title: Specific vs general cognitive remediation for executive functioning in schizophrenia: a multicenter randomized trial.
abstract: BACKGROUND
  This study assesses the benefits of an individualized therapy (RECOS program) compared with the more general cognitive remediation therapy (CRT).
  
  
  METHODS
  138 participants took part with 65 randomized to CRT and 73 to RECOS. In the RECOS group, participants were directed towards one of five training modules (verbal memory, visuo-spatial memory and attention, working memory, selective attention or reasoning) corresponding to their key cognitive concern whereas the CRT group received a standard program. The main outcome was the total score on BADS (Behavioural Assessment of Dysexecutive Syndrome) and the secondary outcomes were: cognition (executive functions; selective attention; visuospatial memory and attention; verbal memory; working memory) and clinical measures (symptoms; insight; neurocognitive complaints; self-esteem). All outcomes were assessed at baseline (T1), week 12 (posttherapy, T2), and follow-up (week 36, i.e., 6months posttherapy, T3).
  
  
  RESULTS
  No difference was shown for the main outcome. A significant improvement was found for BADS' profile score for RECOS at T2 and T3, and for CRT at T3. Change in BADS in the RECOS and CRT arms were not significantly different between T1 and T2 (+0.86, p=0.108), or between T1 and T3 (+0.36, p=0.540). Significant improvements were found in several secondary outcomes including cognition (executive functions, selective attention, verbal memory, and visuospatial abilities) and clinician measures (symptoms and awareness to be hampered by cognitive deficits in everyday) in both treatment arms following treatment. Self-esteem improved only in RECOS arm at T3, and working memory improved only in CRT arm at T2 and T3, but there were no differences in changes between arms.
  
  
  CONCLUSIONS
  RECOS (specific remediation) and CRT (general remediation) globally showed similar efficacy in the present trial.
authors.affiliation: Service Universitaire de Réhabilitation, CH Le Vinatier, Bron, France; Cognitive Neuroscience Centre, UMR 5229 CNRS & Claude Bernard University, Université de Lyon, Bron, France. Electronic address: nicolas.franck@ch-le-vinatier.fr.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Franck
authors.affiliation: Service Universitaire de Réhabilitation, CH Le Vinatier, Bron, France.
authors.forename: Chloé
authors.initials: C
authors.lastname: Duboc
authors.affiliation: Service Universitaire de Réhabilitation, CH Le Vinatier, Bron, France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Sundby
authors.affiliation: CH Sainte-Anne, C3RP & Services de Psychiatrie d'adultes HU & 75G17, Paris, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Amado
authors.affiliation: Department of Psychology, Institute of Psychiatry, King's College London, UK.
authors.forename: Til
authors.initials: T
authors.lastname: Wykes
authors.affiliation: CH Saint Jean de Dieu, Lyon, France; Cognitive Neuroscience Centre, UMR 5229 CNRS & Claude Bernard University, Université de Lyon, Bron, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Demily
authors.affiliation: CH Sainte-Anne, C3RP & Services de Psychiatrie d'adultes HU & 75G17, Paris, France.
authors.forename: Corinne
authors.initials: C
authors.lastname: Launay
authors.affiliation: Pôle universitaire de Psychiatrie, CH Charles Perrens, Bordeaux, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Le Roy
authors.affiliation: CH Niort, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Bloch
authors.affiliation: CH Sainte-Anne, C3RP & Services de Psychiatrie d'adultes HU & 75G17, Paris, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Willard
authors.affiliation: CH Sainte-Anne, C3RP & Services de Psychiatrie d'adultes HU & 75G17, Paris, France.
authors.forename: Aurélia
authors.initials: A
authors.lastname: Todd
authors.affiliation: CH Sainte-Anne, C3RP & Services de Psychiatrie d'adultes HU & 75G17, Paris, France.
authors.forename: François
authors.initials: F
authors.lastname: Petitjean
authors.affiliation: CH Saint Jean de Dieu, Lyon, France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Foullu
authors.affiliation: CH Saint Jean de Dieu, Lyon, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Briant
authors.affiliation: Departement de psychiatrie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors.forename: Marie-Laure
authors.initials: ML
authors.lastname: Grillon
authors.affiliation: Departement de psychiatrie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors.forename: Patricia
authors.initials: P
authors.lastname: Deppen
authors.affiliation: Pôle universitaire de Psychiatrie, CH Charles Perrens, Bordeaux, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Verdoux
authors.affiliation: CHI de Clermont de l'Oise, Centre CRISALID & Service de Psychiatrie Adulte, U669 INSERM PSIGIAM Paris 5 and 11 Universities, France.
authors.forename: Marie-Cécile
authors.initials: MC
authors.lastname: Bralet
authors.affiliation: CH de Ville-Evrard, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Januel
authors.affiliation: Laboratoire de Biostatistique Santé, UMR 5558, CNRS Hôpital Lyon Sud, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Riche
authors.affiliation: Laboratoire de Biostatistique Santé, UMR 5558, CNRS Hôpital Lyon Sud, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Roy
authors.affiliation: Departement de psychiatrie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors.forename: Pascal
authors.initials: P
authors.lastname: Vianin
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000209:etiology* / Q000534:rehabilitation*; D004311:Double-Blind Method; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012073:Remedial Teaching / Q000379:methods*; D012559:Schizophrenia / Q000150:complications*; D016896:Treatment Outcome