Acceptability of cognitive remediation for schizophrenia: a systematic review and meta-analysis of randomized controlled trials
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Background: Acceptability is an important factor for predicting intervention use and potential treatment outcomes in psychosocial interventions. Cognitive remediation (CR) improves cognition and functioning in people with a diagnosis of schizophrenia, but its acceptability, and the impact of participants and treatment characteristics, remain to be investigated. Few studies provide a direct measure of acceptability, but treatment drop-out rates are often available and represent a valid surrogate. Method: The systematic search conducted for the most comprehensive CR outcomes database for schizophrenia was updated in December 2020. Eligible studies were randomized clinical trials comparing CR with any other control condition in patients diagnosed with schizophrenia spectrum disorders and that also reported drop-out in treatment and control arms separately. Acceptability was measured as odd-ratios (OR) of drop-out. Results: Of 2119 identified reports, 151 studies, reporting 169 comparisons between CR and control interventions with 10 477 participants were included in the analyses. The overall rate of drop-out was 16.58% for CR programs and 15.21% for control conditions. In the meta-analysis, no difference emerged between CR interventions and controls [OR 1.10, 95% confidence interval (CI) 0.96–1.25, p = 0.177]. Factors improving acceptability were: inpatient only recruitment, participants with fewer years of education and lower premorbid IQ, the presence of all CR core elements, and the presence of techniques to transfer cognitive gains into real-world functioning. Conclusions: CR for people diagnosed with schizophrenia is effective and has a good acceptability profile, similar to that of other evidence-based psychosocial interventions.
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Understanding acceptability of an intervention is crucial as it can inform clinicians about factors that promote participation and potential barriers to treatment delivery.
“Understanding acceptability of an intervention is crucial as it can inform clinicians about factors that promote participation and potential barriers to treatment delivery [40].”
From Examining cognitive behavioral therapy interventions for unaccompanied minors: a systematic review and qualitative research synthesis. (2025) · cites this paper as [40]
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- Authors
- Vita, A., Barlati, S., Ceraso, A., Deste, G., Nibbio, G., & Wykes, T.
- Affiliations
- Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT)
- University of Brescia (IT)
- King's College London (GB)
- Corresponding author
- Barlati, Stefano
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2022-03-08
- Volume
- 53
- Issue
- 8
- Pages
- 3661-3671
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC10277755
- OpenAlex
- W4220671420
- Cited by
- 74
- References
- 52
- Citations by year
- 2026: 10 · 2025: 18 · 2024: 22 · 2023: 15 · 2022: 9
- FWCI
- 2.75
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Psychological Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion)
- Research Portal (King's College London) (submittedVersion, cc-by)
- Funders
- South London and Maudsley NHS Foundation Trust
- NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust/Institute of Cancer Research
- National Institute for Health and Care Research (NF-SI-0514-10028, RP-PG-0612-20002)
- Department of Health and Social Care
- King's College London
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- cognitive remediation, schizophrenia, acceptability, treatment discontinuation, psychosocial interventions, schizophrenia spectrum disorders, premorbid intelligence, educational attainment
- MeSH terms
- Cognitive Remediation, Cognition, Humans, Schizophrenia, Randomized Controlled Trials as Topic, Treatment Outcome
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