title: A Meta-analytic Review of Non-specific Effects in Randomized Controlled Trials of Cognitive Remediation for Schizophrenia.
abstract: Cognitive remediation (CR) has been found to improve cognitive performance among adults with schizophrenia in randomized controlled trials (RCTs). However, improvements in cognitive performance are often observed in the control groups of RCTs as well. There has been no comprehensive examination of change in control groups for CR, which may inform trial methodology and improve our understanding of measured outcomes for cognitive remediation. In this meta-analysis, we calculated pre-post change in cognitive test performance within control groups of RCTs in 32 CR trials (n = 794 participants) published between 1970 and 2011, and examined the association between pre-post change and sample size, duration of treatment, type of control group, and participants' age, intelligence, duration of illness, and psychiatric symptoms. Results showed that control groups in CR trials showed small effect size changes (Cohen's d = 0.12 ± 0.16) in cognitive test performance over the trial duration. Study characteristics associated with pre-post change included participant age and sample size. These findings suggest attention to change in control groups may help improve detection of cognitive remediation effects for schizophrenia.
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, 300 George St., New Haven, CT, 06511, USA.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Radhakrishnan
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, 300 George St., New Haven, CT, 06511, USA.
authors.forename: Brian D
authors.initials: BD
authors.lastname: Kiluk
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, 300 George St., New Haven, CT, 06511, USA. Jack.Tsai@yale.edu.|Psychiatry Service, VA Connecticut Health Care System, 950 Campbell Ave., West Haven, CT, 06516, USA. Jack.Tsai@yale.edu.|Veterans Affairs New England Mental Illness Research Education and Clinical Center, 950 Campbell Ave., 151D, West Haven, CT, 06516, USA. Jack.Tsai@yale.edu.
authors.forename: Jack
authors.initials: J
authors.lastname: Tsai
mesh_terms: D003071:Cognition; D015928:Cognitive Behavioral Therapy; D035061:Control Groups; D006801:Humans; D009483:Neuropsychological Tests; D016032:Randomized Controlled Trials as Topic; D012559:Schizophrenia / Q000628:therapy*; D012565:Schizophrenic Psychology
keywords: Cognitive remediation; Placebo; Randomized controlled trial; Schizophrenia