Cognitive recognition helps improve cognition and functioning in people with schizophrenia, according to a recent analysis published in JAMA Psychiatry.
Despite the benefits of cognitive recognition behavioral training in improving cognition, the industry remains reluctant to incorporate the training into treatment, the researchers said.
The researchers conducted a systematic review and meta-analysis using the PubMed, Scopus, and PsycInfo databases. They searched studies published between 2011 and 2020. The analysis included 130 studies reporting 146 cognitive recognition comparisons with a total of 8,851 participants.
The researchers found an “overall positive” impact of cognitive recognition on functioning and cognition. The researchers found a small effect of cognitive recognition on primary outcomes (global cognition: d, 0.29 [95% CI, 0.24-0.34]; P < .001; 135 comparisons; global functioning: d, 0.22 [95% CI, 0.16-0.29]; P < .001; 95 comparisons). Fewer years of education and lower IQ were associated with larger improvements.
Although significant asymmetry in the funnel plot emerged for global functioning, it is possible that this observation might be better explained by clinical and methodological heterogeneity between included studies rather than by publication bias. The researchers also limited their search to studies published in English, which may have led to publication bias.
“These findings represent a solid foundation for including cognitive recognition consistently in national and international treatment recommendations,” the researchers concluded.
“It is an evidence-based treatment, with the potential to be introduced as an element of standard care rather than an optional intervention targeting selected individuals. Because pharmacological treatment exerts limited effects on cognitive deficits and clinical remission does not necessarily result in functional recovery, widespread implementation of cognitive recognition could be a game-changer for achieving the patient’s personal recovery goals.”
Disclosures: One author reported receiving grants from the National Institute for Health Research during the conduct of the study and is the creator of CIRCuiTs, a cognitive remediation software.
Vita A, Barlati S, Ceraso A, et al. Effectiveness, core elements, and moderators of response of cognitive remediation for schizophrenia: A systematic review and meta-analysis of randomized clinical trials. JAMA Psychiatry. Published online April 20, 2021. doi:10.1001/jamapsychiatry.2021.0620