Guanfacine augmentation of a combined intervention of computerized cognitive remediation therapy and social skills training for schizotypal personality disorder
Open accessAbstract
OBJECTIVE: Impaired cognition is a hallmark of schizophrenia spectrum disorders, including schizotypal personality disorder, and it is the best predictor of functional outcome. Cognitive remediation therapy has demonstrated efficacy for improving cognition, augmenting other rehabilitation efforts in schizophrenia, and effecting gains in real-world functioning. Pharmacological augmentation of cognitive remediation has been attempted, but the effects of augmentation on combined therapies, such as cognitive remediation and social skills training, have not been studied. METHODS: Twenty-eight participants with schizotypal personality disorder enrolled in an 8-week, randomized, double-blind, placebo-controlled trial of guanfacine plus cognitive remediation and social skills training (15 guanfacine, 13 placebo). Cognition was assessed with the MATRICS (Measurement and Treatment Research to Improve Cognition in Schizophrenia) Consensus Cognitive Battery (MCCB), social cognition with the Movie for the Assessment of Social Cognition (MASC), and functional capacity with the University of California San Diego Performance-Based Skills Assessment (UPSA). RESULTS: A statistically significant pre- versus posttreatment effect was observed for MCCB speed of processing, verbal learning, and visual learning and UPSA total score. A significant time-by-medication (guanfacine, placebo) interaction was observed for MCCB reasoning and problem solving and UPSA total score; the time-by-treatment interaction approached significance for MASC hypomentalizing errors. CONCLUSIONS: Both guanfacine and cognitive remediation plus social skills training were well tolerated, with no side effects or dropouts. Participants treated with cognitive remediation, social skills training, and guanfacine demonstrated statistically significant improvements in reasoning and problem solving, as well as in functional capacity and possibly social cognition, compared with those treated with cognitive remediation, social skills training, and placebo. Cognitive remediation plus social skills training may be an appropriate intervention for individuals with schizotypal personality disorder, and guanfacine appears to be a promising pharmaceutical augmentation to this psychosocial intervention.
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Guanfacine significantly enhances beneficial effects of cognitive remediation in schizotypal patients.
“and significantly enhance the beneficial effects of cognitive remediation (McClure et al., 2019) in schizotypal patients”
From Guanfacine’s mechanism of action in treating prefrontal cortical disorders: Successful translation across species (2020) · cites this paper as McClure et al., 2019
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- Authors
- McClure, M. M., Graff, F., Triebwasser, J., Perez-Rodriguez, M., Rosell, D. R., Koenigsberg, H., Hazlett, E. A., Siever, L. J., Harvey, P. D., & New, A. S.
- Affiliations
- Fairfield University (US)
- Department of Psychiatry, Mt. Sinai School of Medicine, New York (McClure, Perez-Rodriguez, Rosell, Koenigsberg, Hazlett, Siever, New); Department of Psychology, Fairfield University, Fairfield, Conn. (McClure); War Related Illness and Injury Study Center, VA New Jersey Health Care System, East Orange (Graff); Department of Veterans Affairs, VISN2 Mental Illness Research, Education, and Clinical Center, Bronx, N.Y. (Triebwasser, Koenigsberg, Hazlett, Siever); Department of Psychiatry, University of Miami...
- Venue
- American Journal of Psychiatry
- Published
- 2019-04-01
- Volume
- 176
- Issue
- 4
- Pages
- 307-314
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC6443471
- OpenAlex
- W2909163604
- Cited by
- 38
- References
- 41
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 4 · 2023: 7 · 2022: 4 · 2021: 2 · 2020: 7 · 2019: 6
- FWCI
- 3.78
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- DigitalCommons - Fairfield (Fairfield University) (submittedVersion)
- Funders
- U.S. Department of Veterans Affairs (IK6CX001738, I01 CX001451)
- National Institute of Mental Health (R01MH097799)
- 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 › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- guanfacine, schizotypal personality disorder, cognitive remediation, social skills training, drug augmentation, cognitive impairment, social cognition, functional capacity, reasoning and problem solving, processing speed
- MeSH terms
- Cognitive Remediation, Adult, Combined Modality Therapy, Double-Blind Method, Female, Humans, Male, Middle Aged, Neuropsychological Tests, Schizotypal Personality Disorder, Guanfacine, Adrenergic alpha-2 Receptor Agonists, Social Skills
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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