title: Cognitive remediation therapy in adolescents with early-onset schizophrenia: a randomized controlled trial.
abstract: OBJECTIVE
  Cognitive impairment is an enduring and functionally relevant feature of early-onset schizophrenia (EOS). Cognitive remediation therapy (CRT) improves cognition and functional outcome in adults with schizophrenia, although data in adolescents with EOS remain scarce. The purpose of this study is to examine the efficacy of CRT in improving cognition and functional outcomes in a sample of symptomatically stable but cognitively disabled adolescents with EOS.
  
  
  METHODS
  We performed a randomized, controlled trial of individually delivered CRT plus treatment-as-usual compared with treatment-as-usual (TAU). Fifty adolescents with EOS were randomly assigned to receive CRT (n = 25) or TAU (n = 25) and were included in an intention-to-treat analysis. Clinical symptoms and cognitive and functional performance were assessed before and after treatment in both groups and after 3 months in the CRT group. Cognitive domains were defined according to the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) consensus battery and averaged in a global cognitive composite score.
  
  
  RESULTS
  After CRT, significant improvements were found in verbal memory and executive functions, with medium-to-large effect sizes (ES). The derived cognitive composite score showed an improvement after the treatment, with a large ES. This change was reliable in more than two-thirds of the treated patients. Medium-sized ES were found for improvements after CRT in daily living and adaptive functioning, whereas large ES were observed for improvements in family burden. With the exception of functional gains, these changes were maintained after 3 months.
  
  
  CONCLUSIONS
  CRT appears to be a useful intervention strategy for adolescents with EOS. Cognitive improvements can be achieved through CRT, although further research is warranted to determine the durability of functional gains. Clinical trial registration information-Cognitive Remediation Therapy (CRT) in Adolescents With EOS; www.clinicaltrials.gov; NCT01701609.
authors: Hospital Clínic of Barcelona, and with Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM), Madrid. Electronic address: opuig@clinic.ub.es.
authors: Olga
authors: O
authors: Puig
authors: Unitat Esquizofrènia Clínic, Hospital Clínic of Barcelona, CIBERSAM, and IDIBAPS.
authors: Rafael
authors: R
authors: Penadés
authors: Hospital Clínic of Barcelona, CIBERSAM, and the Unitar Esquizofrènia Clínic, Spain.
authors: Inmaculada
authors: I
authors: Baeza
authors: Hospital Clínic of Barcelona, and with Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM), Madrid.
authors: Elena
authors: E
authors: De la Serna
authors: Hospital Clínic of Barcelona, and with Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM), Madrid.
authors: Vanessa
authors: V
authors: Sánchez-Gistau
authors: Unitat Esquizofrènia Clínic, Hospital Clínic of Barcelona, CIBERSAM, IDIBAPS, and with the UB.
authors: Miquel
authors: M
authors: Bernardo
authors: Hospital Clínic of Barcelona, CIBERSAM, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), and with the University of Barcelona (UB).
authors: Josefina
authors: J
authors: Castro-Fornieles
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D001526:Behavioral Symptoms / Q000523:psychology / Q000628:therapy; D003071:Cognition; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D056344:Executive Function; D005192:Family Health; D005260:Female; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D008568:Memory; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D012565:Schizophrenic Psychology; D016896:Treatment Outcome
keywords: CRT; cognition; cognitive remediation therapy; early-onset; functional outcome