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Randomized Controlled Trial
. 2011 Jun;41(6):1253-61.
doi: 10.1017/S0033291710001765. Epub 2010 Sep 22.

Mechanisms of functional improvement in a 2-year trial of cognitive enhancement therapy for early schizophrenia

S M Eack  1 , M F Pogue-Geile, D P Greenwald, S S Hogarty, M S Keshavan
Affiliations
Randomized Controlled Trial

Mechanisms of functional improvement in a 2-year trial of cognitive enhancement therapy for early schizophrenia

S M Eack et al. Psychol Med. 2011 Jun.

Abstract

Background: Cognitive rehabilitation has emerged as an effective treatment for addressing cognitive impairments and functional disability in schizophrenia; however, the degree to which changes in various social and non-social cognitive processes translate into improved functioning during treatment remains unclear. This research sought to identify the neurocognitive and social-cognitive mechanisms of functional improvement during a 2-year trial of cognitive enhancement therapy (CET) for early-course schizophrenia.

Method: Patients in the early course of schizophrenia were randomly assigned to CET (n=31) or an enriched supportive therapy control (n=27) and treated for up to 2 years. A comprehensive neurocognitive assessment battery and the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) were completed annually, along with measures of functioning. Mediator analyses using mixed-effects growth models were conducted to examine the effects of neurocognitive and social-cognitive improvement on functional change.

Results: Improvements over 2 years in neurocognition and the emotion management branch of the MSCEIT were found to be significantly related to improved functional outcome in early-course schizophrenia patients. Neurocognitive improvement, primarily in executive functioning, and social-cognitive change in emotion management also mediated the robust effects of CET on functioning.

Conclusions: Improvements in neurocognition and social cognition that result from cognitive rehabilitation are both significant mediators of functional improvement in early-course schizophrenia. Cognitive rehabilitation programs for schizophrenia may need to target deficits in both social and non-social cognition to achieve an optimal functional response.

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Conflict of interest statement

Declaration of Interest

The authors report no competing financial or other conflicts of interest with this research.

Figures

Figure 1
Figure 1
Neurocognitive and Social-Cognitive Mediators of the Effects of Cognitive Enhancement Therapy on Functional Outcome in Early Course Schizophrenia (N = 58). Note. Regression weights on the left and right of the slash (/) represent direct and indirect effects, respectively. *p < .05, **p < .01
See this image and copyright information in PMC

References

    1. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology. 1986;51(6):1173–1182. - PubMed
    1. Braw Y, Bloch Y, Mendelovich S, Ratzoni G, Gal G, Harari H, Tripto A, Levkovitz Y. Cognition in young schizophrenia outpatients: comparison of first-episode with multiepisode patients. Schizophrenia Bulletin. 2008;34(3):544–554. - PMC - PubMed
    1. Brekke JS, Hoe M, Green MF. Neurocognitive change, functional change and service intensity during community-based psychosocial rehabilitation for schizophrenia. Psychological Medicine (in press) - PubMed
    1. Brekke JS, Hoe M, Long J, Green MF. How Neurocognition and Social Cognition Influence Functional Change During Community-Based Psychosocial Rehabilitation for Individuals with Schizophrenia. Schizophrenia Bulletin. 2007;33(5):1247–1256. - PMC - PubMed
    1. Buchanan RW, Heinrichs DW. The Neurological Evaluation Scale (NES): a structured instrument for the assessment of neurological signs in schizophrenia. Psychiatry Research. 1989;27(3):335–350. - PubMed

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