Cognitive remediation combined with an early intervention service in first episode psychosis.
OBJECTIVE
This randomised clinical trial assessed the effects of a 16-week cognitive remediation programme (NEUROCOM) combined with an early intervention service (EIS) vs. EIS alone.


METHODS
One hundred and seventeen patients with first episode psychosis were randomly assigned to 4 months cognitive remediation combined with EIS vs. EIS alone. Statistical analysis of effect was based on intention to treat.


RESULTS
A total of 98 patients (83.8%) participated in post-training assessments at 4 months and 92 (78.6%) in 12-month follow-up assessments. No effects were found on the primary outcome measure functional capacity. At the post-training assessment, the intervention group had improved significantly on Rosenberg Self-Esteem Scale (Cohen's d=0.54, P=0.01), Positive and Negative Symptoms Scale (PANSS), General Psychopathology Scale (Cohen's d=0.51, P=0.05) and the verbal learning domain (Cohen's d=0.46, P=0.02). At follow-up assessment, the intervention group retained the significant improvements on the verbal learning domain (Cohen's d=0.58, P<0.05). Furthermore, significant improvements were observed on the working memory domain (Cohen's d=0.56, P=0.01) and PANSS positive symptoms (Cohen's d=0.44, P=0.04), while improvement on the composite score was marginally significant (Cohen's d=0.34, P=0.05).


CONCLUSIONS
In accordance with other cognitive remediation programmes, this programme demonstrates some immediate and long-term effect on cognitive functioning, symptoms and self-esteem.
Aarhus University Hospital, Risskov, Denmark.
T
T
Østergaard Christensen
L
L
Vesterager
G
G
Krarup
B B
BB
Olsen
M
M
Melau
C
C
Gluud
M
M
Nordentoft
D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D061345:Early Medical Intervention / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000628:therapy*; D012649:Self Concept; D016037:Single-Blind Method; D016896:Treatment Outcome; D055815:Young Adult
cognition; early intervention; first episode psychosis; remediation