Cognitive remediation improves memory and psychosocial functioning in first-episode psychiatric out-patients
| Autor: | Ian B. Hickie, Marie Antoinette Redoblado-Hodge, Sharon L. Naismith, Melanie A. Porter, Daniel F. Hermens, Rico S.C. Lee |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Employment Male medicine.medical_specialty Psychosis Adolescent medicine.medical_treatment neuropsychology Ambulatory Care Facilities law.invention Young Adult 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Memory law Social cognition Early Medical Intervention medicine Humans Learning Interpersonal Relations psychosis Psychiatry Applied Psychology First episode Depressive Disorder Major Cognitive Behavioral Therapy Neuropsychology Original Articles medicine.disease 030227 psychiatry early intervention Psychiatry and Mental health Treatment Outcome Psychotic Disorders Cognitive remediation therapy depression Cognitive therapy Cognitive remediation Female Cognition Disorders Psychology Psychosocial 030217 neurology & neurosurgery Clinical psychology |
| Zdroj: | Psychological Medicine |
| ISSN: | 1469-8978 0033-2917 |
| DOI: | 10.1017/s0033291712002127 |
| Popis: | BackgroundCognitive remediation (CR) is an effective treatment for several psychiatric disorders. To date, there have been no published studies examining solely first-episode psychiatric cohorts, despite the merits demonstrated by early intervention CR studies. The current study aimed to assess the effectiveness of CR in patients with a first-episode of either major depression or psychosis.MethodFifty-five patients (mean age = 22.8 years, s.d. = 4.3) were randomly assigned to either CR (n = 28) or treatment as usual (TAU; n = 27). CR involved once-weekly 2-h sessions for a total of 10 weeks. Patients were comprehensively assessed before and after treatment. Thirty-six patients completed the study, and analyses were conducted using an intent-to-treat (ITT) approach with all available data.ResultsIn comparison to TAU, CR was associated with improved immediate learning and memory controlling for diagnosis and baseline differences. Similarly, CR patients demonstrated greater improvements than TAU patients in psychosocial functioning irrespective of diagnosis. Delayed learning and memory improvements mediated the effect of treatment on psychosocial functioning at a marginal level.ConclusionsCR improves memory and psychosocial outcome in first-episode psychiatric out-patients for both depression and psychosis. Memory potentially mediated the functional gains observed. Future studies need to build on the current findings in larger samples using blinded allocation and should incorporate longitudinal follow-up and assessment of potential moderators (e.g. social cognition, self-efficacy) to examine sustainability and the precise mechanisms of CR effects respectively. |
| Databáze: | OpenAIRE |
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