It is all in the factors: effects of cognitive remediation on symptom dimensions.
BACKGROUND
Cognitive remediation (CR) aims primarily to improve cognition and functional outcomes. However, a limited number of studies reported a positive effect on symptoms. This limited effect may be because the symptom clusters considered are too broad and heterogeneous. This study explores, for the first time, the effect of CR on five empirically defined symptom dimensions of schizophrenia.


METHODS
Participants were patients with schizophrenia taking part in a randomised controlled trial comparing CR plus treatment as usual (CR, N=43) to treatment as usual (TAU, N=42). All participants were assessed at baseline and 14-weeks (i.e. at the conclusion of treatment for the CR group) with the Positive and Negative Symptoms Scale (PANSS). Five symptom dimensions were derived from the PANSS scores: Positive (POS), Negative (NEG), Disorganised (DIS), Excited (EXC) and Emotional Distressed (EMD).


RESULTS
After CR, the therapy group had a significant reduction in DIS and NEG symptom dimensions compared to the TAU group. The traditional PANSS factors showed no effect of CR on symptoms.


CONCLUSIONS
CR can have not only a positive effect on disorganisation but also on negative symptoms. Using detailed symptom dimensions can characterise more accurately the effect of CR on symptom of schizophrenia.
King's College London, Institute of Psychiatry, London, UK.
Matteo
M
Cella
King's College London, Institute of Psychiatry, London, UK.
Clare
C
Reeder
King's College London, Institute of Psychiatry, London, UK.
Til
T
Wykes
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000534:rehabilitation*; D012565:Schizophrenic Psychology; D016037:Single-Blind Method; D016896:Treatment Outcome; D055815:Young Adult
Cognition; Cognitive remediation; Negative symptoms; PANSS; Positive symptoms