title: One-year randomized controlled trial and follow-up of integrated neurocognitive therapy for schizophrenia outpatients.
abstract: OBJECTIVE
  Cognitive remediation (CR) approaches have demonstrated to be effective in improving cognitive functions in schizophrenia. However, there is a lack of integrated CR approaches that target multiple neuro- and social-cognitive domains with a special focus on the generalization of therapy effects to functional outcome.
  
  
  METHODS
  This 8-site randomized controlled trial evaluated the efficacy of a novel CR group therapy approach called integrated neurocognitive therapy (INT). INT includes well-defined exercises to improve all neuro- and social-cognitive domains as defined by the Measurement And Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative by compensation and restitution. One hundred and fifty-six outpatients with a diagnosis of schizophrenia or schizoaffective disorder according to DSM-IV-TR or ICD-10 were randomly assigned to receive 15 weeks of INT or treatment as usual (TAU). INT patients received 30 bi-weekly therapy sessions. Each session lasted 90min. Mixed models were applied to assess changes in neurocognition, social cognition, symptoms, and functional outcome at post-treatment and at 9-month follow-up.
  
  
  RESULTS
  In comparison to TAU, INT patients showed significant improvements in several neuro- and social-cognitive domains, negative symptoms, and functional outcome after therapy and at 9-month follow-up. Number-needed-to-treat analyses indicate that only 5 INT patients are necessary to produce durable and meaningful improvements in functional outcome.
  
  
  CONCLUSIONS
  Integrated interventions on neurocognition and social cognition have the potential to improve not only cognitive performance but also functional outcome. These findings are important as treatment guidelines for schizophrenia have criticized CR for its poor generalization effects.
authors.affiliation: University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland;
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Mueller
authors.affiliation: University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
authors.forename: Stefanie J
authors.initials: SJ
authors.lastname: Schmidt
authors.affiliation: University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; roder@sunrise.ch.
authors.forename: Volker
authors.initials: V
authors.lastname: Roder
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D017063:Outcome Assessment, Health Care; D010045:Outpatients; D011618:Psychotic Disorders / Q000628:therapy*; D012559:Schizophrenia / Q000628:therapy*; D012919:Social Behavior; D012938:Social Perception; D056345:Theory of Mind; D013997:Time Factors; D055815:Young Adult