Cognitive Enhancement Therapy (CET), a cognitive remediation (CR) approach, may improve functional capacity in people with schizophrenia according to a recent study published in the Journal of Psychiatric Research. Few studies have examined the relationship between CR and/or CET and functional capacity in people with schizophrenia.
To add to the literature on this topic, the researchers conducted secondary analysis of a multi-site CET trial using 86 individuals recently diagnosed with a schizophrenia spectrum disorder. The participants stayed on any prescribed medication through the duration of the trial.
The study found patients who received CET reported improved attention/vigilance, working memory, social cognition, and processing speed. Changes in these areas were related to changes in functional capacity. The most notable changes occurred mid-trial, at 6 months, with insignificant benefits noted at 18 months.
The researchers also found changes in overall cognition, attention/vigilance, working memory, MATRICS Consensus Cognitive Battery (MCCB) scores, social cognition, total Managing Emotions subscale of the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT), Hinting Task, and The Awareness of Social Inferences Test (TASIT). All predicted changes in functional capacity.
Although CR is not widely available, “practitioners can incorporate identified mechanisms into person-centered treatment plans by means of attention training exercises, psychoeducation about social cognition concepts, and in-vivo practice of social cognitive abilities,” the researchers stated.
The researchers note the attrition rate was high for this study — 43% — which affected statistical power. They also note the lack of diversity in the study. The Hispanic population represented about 8% of the trial population, which is less than the United States population, which is about 19%.
Still, the study may prompt additional CET studies. “Attention/vigilance and social cognition are promising mechanisms of functional capacity,” the researchers concluded.
“Further research on CET, focusing on key components that were identified in this study, is necessary for confirming the cognitive mechanisms of functional capacity improvement (Kraemer et al., 2002). Additionally, we recommend further research expanded to community functioning as an outcome, which is highly multidetermined based on environmental and motivational factors.”
Flores AT, Hogarty SS, Mesholam-Gately RI, Barrio C, Keshavan MS, Eack SM. Cognitive gains as a mechanism of functional capacity improvement in schizophrenia: Results from a multi-site randomized controlled trial. J Psychiatr Res. 2022;151:554-560. doi:10.1016/j.jpsychires.2022.05.016