Cognitive Rehabilitation Therapy (CRT) effects in people with schizophrenia: An article review

Background and Aim : Cognitive deficits are a prominent, stable feature of schizophrenia from the time of the first episode throughout the illness. Cognitive rehabilitation has been defined as the therapeutic process of increasing or improving an individual’s capacity to process and use incoming information to allow increased functioning in everyday life . Also, it has been recently defined as a behavioral training based intervention that aims to improve cognitive processes (attention, memory, executive function, social cognition or metacognition) with the goal of durability and generalization . Cognitive rehabilitation strategies can be distinguished into two main models: compensatory and restorative. the restorative methods are based on knowledge deriving from neurosciences, in particular, neuronal plasticity, and have the objective to correct a specific deficit trying to repair the specific underlying compromised function using the capacity of the brain to develop and repair itself throughout the whole life.Methods : A systematic search involved looking at the following databases: ProQuest, Pub Med, MEDLINE, and Google Scholars. The following terms were used to commence the search: schizophrenia, cognitive remediation, cognitive training, neurocognitive training, cognitive rehabilitation. 20 articles from 2000 – 2018 were initially identified. Finally, 9 randomized control trials were selected according to the criteria (RCT studies that used the restorative model in CRT).Results : All studies evaluated neurocognition and used functional assessments. 4 studies used social cognition tests that were improved after CRT. Results demonstrate the efficacy of cognitive remediation interventions on cognitive and psychosocial functioning of people with schizophrenia. These benefits appear to be especially relevant for chronic and severe patients with schizophrenia.Conclusion : It seems that targeting cognitive impairments in the early course of schizophrenia can result not only in cognitive improvement, but also in significant functional benefits in such important domains as social functioning, employment, and role functioning. The combination of psychiatric rehabilitation with cognitive remediation that includes both drill and practice and strategy coaching was significantly more likely to impact psychosocial outcomes than when psychiatric rehabilitation was provided alongside cognitive remediation that only used a drill and practice approach.

Keywords:

cognitive training , cognitive rehabilitation , schizophrenia , neurocognitive training