Cognitive impairment is increasingly regarded as a core aspect of schizophrenia. It is associated with poor functional outcome, may represent a rate limiting factor in rehabilitation programs and is not largely influenced by pharmacological interventions.
Several studies suggest the efficacy of cognitive training programs and advice their inclusion in treatment strategies, while others discourage clinical application.
We recently completed a study involving three Mental Health Departments located in the South of Italy and coordinated by the Department of Psychiatry of the University of Naples SUN. Fifty-eight patients with either a diagnosis of schizophrenia or schizoaffective disorder were recruited and randomly allocated to one of two rehabilitation programs: Social Skill Training (SST) + Computerized Cognitive Training (CCT) (Group A) and usual rehabilitation activities of the Department (Group B). The active treatment phase lasted 6 months. Psychopathological aspects, as well as psychosocial and neurocognitive functioning, were assessed both before and after treatment. Group A subjects participated in two one-hour sessions of CCT and one two-hour session of SST. Group B patients spent an equivalent amount of time in the usual rehabilitation activities.
The two groups did not differ on baseline clinical, neurocognitive and psychosocial variables.
At the end of treatment, a worsening of the negative dimension was observed in group B, but not in group A, in which a significant improvement of two psychosocial indices (participation in family life and availability to work) was found.
The experimental program (SST+CCT) was more effective than usual rehabilitation activities of the departments.