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Cited by 291Schizophrenia research and treatmentDementia and Cognitive Impairment ResearchMental Health and Psychiatry

Cognitive enhancement therapy for early-course schizophrenia: effects of a two-year randomized controlled trial

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Eack, Shaun M., Greenwald, Deborah P., Hogarty, Susan S., Cooley, Susan J., DiBarry, Ann Louise, Montrose, Debra M., Keshavan, Matcheri S.·2009·Psychiatric Services
DOI 10.1176/ps.2009.60.11.1468PMC PMC3693549
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Abstract

Objective-The early application of cognitive rehabilitation may afford long-term functional benefits to patients with schizophrenia.This study examined the two-year effects of an integrated neurocognitive and social-cognitive rehabilitation program, cognitive enhancement therapy (CET), on cognitive and functional outcomes in early course schizophrenia.Method-Early course outpatients (mean illness duration = 3.19±2.24years) with schizophrenia or schizoaffective disorder were randomly assigned to CET (n = 31) or enriched supportive therapy (EST) (n = 27), an illness management intervention utilizing psychoeducation and applied coping strategies, and treated for 2 years.Multivariate composite indexes of cognitive, social adjustment, and symptomatology domains were derived from assessment batteries administered annually by computer-based tests and raters not blind to treatment assignment.Results-Of the 58 patients randomized and treated, 49 and 46 completed 1 and 2 years of treatment, respectively.Intent to treat analyses showed significant differential effects favoring CET on social cognition, cognitive style, social adjustment, and symptomatology composites during the first year of treatment.After two years, moderate effects (d = .46)were observed favoring CET at enhancing neurocognitive function.Strong differential effects (d > 1.00) on social cognition, cognitive style, and social adjustment composites remained at year 2, and also extended to measures of symptomatology, particularly negative symptoms.Conclusions-CET appears to be an effective approach to the remediation of cognitive deficits in early schizophrenia that may help reduce disability among this population.The remediation of such deficits should be an integral component of early intervention programs treating psychiatrically stable schizophrenia outpatients.Schizophrenia is a chronic and disabling mental disorder that is characterized by related deficits in cognition, functioning, and adjustment.The significant personal and societal costs of the disorder (1), its frequent deteriorating course (2, 3), and the consistent negative prognosis associated with untreated illness (4), all highlight the importance of early applications of evidence-based interventions to reduce long-term morbidity (5).Cognitive impairments, in particular, are promising targets for early intervention due to their early emergence (6), persistence (7), and contribution to functional outcome (8).Unfortunately,

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  • In some studies of behavioral interventions, younger people with schizophrenia and those early in the course of illness appeared to benefit more from cognitive remediation than older people.

    “In some studies of behavioral interventions not reviewed comprehensively in this report, younger people with schizophrenia and those early in the course of illness appeared to benefit more from cognitive remediation than older people.63–65”

    From Clinical trials of potential cognitive-enhancing drugs in schizophrenia: what have we learned so far? (2013) · cites this paper as [65]

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Authors
Eack, S. M., Greenwald, D. P., Hogarty, S. S., Cooley, S. J., DiBarry, A. L., Montrose, D. M., & Keshavan, M. S.
Affiliations
  • University of Pittsburgh (US)
  • Harvard University (US)
Corresponding author
Keshavan, Matcheri S.
ORCID
Venue
Psychiatric Services
Publisher
American Psychiatric Association Publishing
Published
2009-11
Volume
60
Issue
11
Pages
1468-1476
ISSN
  • 0022-1597 (ISSN-L)
  • 1075-2730
  • 1557-9700
DOI
10.1176/ps.2009.60.11.1468
PMC
PMC3693549
OpenAlex
W2067846071
Cited by
289
References
46
Citations by year
2026: 5 · 2025: 5 · 2024: 9 · 2023: 11 · 2022: 14 · 2021: 13 · 2020: 17 · 2019: 35 · 2018: 13 · 2017: 12 · 2016: 24 · 2015: 19 · 2014: 19 · 2013: 31 · 2012: 30
FWCI
12.95
Type
journal article
Language
en
Open access
Locations
  • Psychiatric Services (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (MH 79537, MH-60902, R01MH060902, F31MH079537)
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
cognitive enhancement therapy, schizoaffective disorder, cognitive rehabilitation, neurocognitive function, social cognition, cognitive style, social adaptation, negative symptoms, early intervention, illness management, functional outcome
MeSH terms
Adult, Cognition Disorders, Combined Modality Therapy, Female, Humans, Male, Neuropsychological Tests, Psychiatric Status Rating Scales, Schizophrenia, Time Factors, Antipsychotic Agents, Cognitive Behavioral Therapy

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