Maree P Reser1, Reneta Slikboer1, Susan L Rossell1,2. 1. 1 Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia. 2. 2 Psychiatry, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia.
Abstract
OBJECTIVE: Cognitive remediation therapy is a moderately effective intervention for ameliorating cognitive deficits in individuals with schizophrenia-related disorders. With reports of considerable variability in individual response to cognitive remediation therapy, we need to better understand factors that influence cognitive remediation therapy efficacy to realise its potential. A systematic review was conducted to identify and evaluate predictors of cognitive outcome. METHODS: An electronic database search was conducted identifying peer-reviewed articles examining predictors of cognitive response to cognitive remediation therapy. RESULTS: A total of 40 articles accounting for 1681 cognitive remediation therapy participants were included; 81 distinct predictors of cognitive response were identified. Data synthesis and discussion focused on 20 predictors examined a minimum three times in different studies. Few of the examined predictors of cognitive outcome following cognitive remediation therapy were significant when examined through systematic review. A strong trend was found for baseline cognition, with reasoning and problem solving and working memory being strongly predictive of within-domain improvement. Training task progress was the most notable cross-domain predictor of cognitive outcome. CONCLUSION: It remains unclear why a large proportion of participants fail to realise cognitive benefit from cognitive remediation therapy. However, when considering only those variables where a majority of articles reported a statistically significant association with cognitive response to cognitive remediation therapy, three stand out: premorbid IQ, baseline cognition and training task progress. Each of these relates in some way to an individual's capacity or potential for change. There is a need to consolidate investigation of potential predictors of response to cognitive remediation therapy, strengthening the evidence base through replication and collaboration.
OBJECTIVE: Cognitive remediation therapy is a moderately effective intervention for ameliorating cognitive deficits in individuals with schizophrenia-related disorders. With reports of considerable variability in individual response to cognitive remediation therapy, we need to better understand factors that influence cognitive remediation therapy efficacy to realise its potential. A systematic review was conducted to identify and evaluate predictors of cognitive outcome. METHODS: An electronic database search was conducted identifying peer-reviewed articles examining predictors of cognitive response to cognitive remediation therapy. RESULTS: A total of 40 articles accounting for 1681 cognitive remediation therapy participants were included; 81 distinct predictors of cognitive response were identified. Data synthesis and discussion focused on 20 predictors examined a minimum three times in different studies. Few of the examined predictors of cognitive outcome following cognitive remediation therapy were significant when examined through systematic review. A strong trend was found for baseline cognition, with reasoning and problem solving and working memory being strongly predictive of within-domain improvement. Training task progress was the most notable cross-domain predictor of cognitive outcome. CONCLUSION: It remains unclear why a large proportion of participants fail to realise cognitive benefit from cognitive remediation therapy. However, when considering only those variables where a majority of articles reported a statistically significant association with cognitive response to cognitive remediation therapy, three stand out: premorbid IQ, baseline cognition and training task progress. Each of these relates in some way to an individual's capacity or potential for change. There is a need to consolidate investigation of potential predictors of response to cognitive remediation therapy, strengthening the evidence base through replication and collaboration.
Authors: Alice M Saperstein; C Jean Choi; Carol Jahshan; David A Lynch; Melanie Wall; Michael F Green; Alice Medalia Journal: Schizophr Res Date: 2021-03-23 Impact factor: 4.939
Authors: Giulia M Giordano; Francesco Brando; Pasquale Pezzella; Maria De Angelis; Armida Mucci; Silvana Galderisi Journal: Front Psychiatry Date: 2022-08-30 Impact factor: 5.435
Authors: Francesc Estrada; Josep Maria Crosas; Maribel Ahuir; Sara Pérez-Muñoz; Wanda Zabala; Raquel Aguayo; Juan David Barbero; Itziar Montalvo; Meritxell Tost; Laura Llauradó; Armand Guardia; Diego Palao; José Antonio Monreal; Javier Labad Journal: Front Psychiatry Date: 2020-07-07 Impact factor: 4.157