Computerized cognitive remediation therapy on cognitive impairment and social function in patients with chronic schizophrenia

Abstract

Background: Patients with schizophrenia may have various disease manifestations, most of which gradually tend toward incurable chronic decline, leading to mental disability. The basic symptoms of the disease can impair social function, whereas long-term hospitalization produces hospitalization syndrome, causing serious damage to social function.

Aim: To investigate the effects of Computerized Cognitive Remediation Therapy (CCRT) on cognitive and social functioning in patients with chronic schizophrenia.

Methods: A retrospective analysis of 120 patients with chronic schizophrenia in Shanghai Pudong New Area Mental Health Center was performed. They were divided into an intervention group (60 cases treated with CCRT combined with conventional medication) and a control group (60 cases treated with conventional medication). After treatment, effects on cognitive function and social roles were observed in both groups. The Positive and Negative Syndrome Scale (PANSS) was used to assess the patients' psychiatric symptoms. The Wisconsin Card Sorting Test (WCST) was used to assess the patients' cognitive functioning, and the Social Functioning Scale for Psychiatric Inpatients (SSPI) was used to assess the social functioning of the inpatient psychiatric patients.

Results: No significant differences were observed in the PANSS, WCST, and SSPI intergroup scores before treatment (P > 0.05). After 2, 4, and 6 wk of therapy, general psychopathological factors, positive symptoms, negative symptoms, and total PANSS scores of PANSS in the intervention group were lower than in the control group (P < 0.05). After 2, 4, and 6 wk of treatment, the number of false responses, number of persistent bugs, and total responses in the WCST were significantly lower in the intervention group than in the control group (P < 0.05), and the amount of completed classification was significantly higher than in the control group (P < 0.05). After 2, 4, and 6 wk of therapy, the SSPI scores were significantly greater than those of the controls (P < 0.05). After 6 wk of treatment, the efficacy rates of the control and intervention groups were 81.67% and 91.67%, respectively. The curative effect in the intervention group was significantly higher than that in the control group (P < 0.05).

Conclusion: CCRT can significantly improve cognitive function and social abilities in patients with chronic schizophrenia.

Keywords: Cognitive function; Computerized cognitive correction therapy; Psychopathological factors; Schizophrenia; Social function.

Figure 1

Technical route flow chart. PANSS: Positive and Negative Syndrome Scale; WCST: Wisconsin card sorting test; SSPI: Scale of social function in psychosis inpatients.

Figure 2

Comparison of positive and negative syndrome scale scores before and after treatment between the two groups of patients. A: Changes in general psychopathological symptom scores before and after treatment in both groups; B: Changes in scores of positive symptoms before and after treatment; C: Changes in scores of negative symptoms before and after treatment; D: Changes in total positive and negative syndrome scale scores before and after treatment in both groups. ^aP < 0.05. PANSS: Positive and Negative Syndrome Scale.

Figure 3

Comparison of Wisconsin Card Sorting Test scores before and after treatment between the two groups of patients. A: Change in the number of errors responses after treatment in both groups; B: Changes in the perseverative responses errors scores before and after treatment in both groups; C: Score changes in the number of patients with response answers before and after treatment in both groups; D: Changes in the number of categories completed before and after treatment in both groups. ^aP < 0.05. RE: Errors responses; RPE: Perseverative responses errors; RA: Response answers; CC: Categories completed.

Figure 4

Comparison of Social Functioning Scale for Psychiatric Inpatients scores before and after treatment between the two groups of patients. A: Changes in daily living skills scores before and after treatment in both groups; B: Changes in the mobility and interaction scores before and after treatment in both groups; C: Changes in the social activity skill scores before and after treatment in both groups; D: Changes in the total Social Functioning Scale for Psychiatric Inpatients scores before and after treatment in both groups. ^aP < 0.05; SSPI: Scale of Social Function in Psychosis Inpatients.