Neurocognition as a predictor of response to evidence-based psychosocial interventions in schizophrenia: what is the state of the evidence?

Abstract

Impairment in functional status is a hallmark of schizophrenia that has been linked to deficits in aspects of neurocognition (e.g., attention, memory, and problem-solving). A growing number of evidence-based behavioral interventions have been developed to address impairment in functional status, yet the relationships between these interventions and neurocognitive impairment are not well-understood. We conducted a synthetic, critical literature review of studies of performance on neurocognitive tests as a predictor of response to evidence-based behavioral treatment in schizophrenia. Behavioral treatments were selected based on the Patient Outcomes Research Team (PORT; Dixon et al., 2010) recommendations for practice and areas of emerging interest. Comprehensive searches of PsychINFO and MEDLINE/PUBMED databases identified 20 relevant studies. Results revealed that: (1) attention and memory measured at study entry were most frequently linked to proximal measures of progress in social skill training programs, (2) composite measures of neurocognitive function, as well as attention, memory and problem-solving, were linked to progress in work therapy and supported employment programs, and comprehensive, integrated programs of psychosocial rehabilitation, while (3) baseline impairment on neurocogntive tests was not shown to limit progress in treatment studies of cognitive-behavioral therapy. The relevance of these findings for clinical practice and future research is discussed.