title: Cognitive remediation improves memory and psychosocial functioning in first-episode psychiatric out-patients.
abstract: BACKGROUND
  Cognitive remediation (CR) is an effective treatment for several psychiatric disorders. To date, there have been no published studies examining solely first-episode psychiatric cohorts, despite the merits demonstrated by early intervention CR studies. The current study aimed to assess the effectiveness of CR in patients with a first-episode of either major depression or psychosis. Method Fifty-five patients (mean age = 22.8 years, s.d. = 4.3) were randomly assigned to either CR (n = 28) or treatment as usual (TAU; n = 27). CR involved once-weekly 2-h sessions for a total of 10 weeks. Patients were comprehensively assessed before and after treatment. Thirty-six patients completed the study, and analyses were conducted using an intent-to-treat (ITT) approach with all available data.
  
  
  RESULTS
  In comparison to TAU, CR was associated with improved immediate learning and memory controlling for diagnosis and baseline differences. Similarly, CR patients demonstrated greater improvements than TAU patients in psychosocial functioning irrespective of diagnosis. Delayed learning and memory improvements mediated the effect of treatment on psychosocial functioning at a marginal level.
  
  
  CONCLUSIONS
  CR improves memory and psychosocial outcome in first-episode psychiatric out-patients for both depression and psychosis. Memory potentially mediated the functional gains observed. Future studies need to build on the current findings in larger samples using blinded allocation and should incorporate longitudinal follow-up and assessment of potential moderators (e.g. social cognition, self-efficacy) to examine sustainability and the precise mechanisms of CR effects respectively.
authors.affiliation: Clinical Research Unit, Brain and Mind Research Institute, University of Sydney, Sydney, Australia. sze.lee@sydney.edu.au
authors.forename: R S C
authors.initials: RS
authors.lastname: Lee
authors.forename: M A
authors.initials: MA
authors.lastname: Redoblado-Hodge
authors.forename: S L
authors.initials: SL
authors.lastname: Naismith
authors.forename: D F
authors.initials: DF
authors.lastname: Hermens
authors.forename: M A
authors.initials: MA
authors.lastname: Porter
authors.forename: I B
authors.initials: IB
authors.lastname: Hickie
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D003072:Cognition Disorders / Q000523:psychology / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003865:Major Depressive Disorder / Q000523:psychology / Q000534:rehabilitation*; D061345:Early Medical Intervention / Q000379:methods*; D004651:Employment; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007858:Learning; D008297:Male; D008568:Memory; D011618:Psychotic Disorders / Q000523:psychology / Q000534:rehabilitation*; D016896:Treatment Outcome; D055815:Young Adult