REPYFLEC cognitive remediation group training in schizophrenia: Looking for an integrative approach

Abstract

Background: Overall results from Cognitive Remediation (CR) indicate robust and long-lasting effects with medium effect size on global cognition and functioning, and a small ES on symptoms present at post-treatment but not at follow-up. However, results are not the same in all CR therapies and in some cases no efficacy results are achieved.

Aims: To develop an integrative intervention taking into account previous efficacious therapies. To evaluate the efficacy of our cognitive remediation group training: Problem Solving and Cognitive Flexibility training (REPYFLEC), with the aim of improving cognition and functioning in schizophrenia patients.

Method: Participants with a diagnosis of schizophrenia or schizoaffective disorder (n=62) were randomized to 32 group sessions of REPYFLEC CR, or to 32 group sessions of activities without specific objectives and focused on leisure. In both groups the sessions were conducted twice a week. Functioning and psychiatric symptoms were measured at baseline (week 0) and thereafter at 8, 16 and 40 weeks. Cognition was measured at weeks 0, 16 and 40. Mixed Models were used to estimate statistical differences.

Results: Patients in the cognitive remediation group demonstrated significant improvements in executive function, negative symptoms and functioning at post-treatment compared with patients in the control group. At 6-month follow-up, significant improvements in executive function and functioning remained.

Conclusion: These results apparently show that REPYFLEC works as cognitive remediation training, improving executive thinking and functioning outcomes compared with a control group.