Computer-assisted cognitive remediation in patients with schizophrenia : effects on symptoms, cognition and psychosocial functioning

Abstract

Background: Cognitive remediation is a behavioural intervention that aims to improve cognitive functioning with the goal of durability and generalisation. Although evidence suggests that computer-assisted cognitive remediation (CACR) improves cognitive functioning in individuals with schizophrenia, it remains unclear whether these effects generalise and lead to improvements in clinical symptoms and psychosocial functioning. The current study aimed to investigate the effects of CACR on clinical symptoms, cognitive functioning and psychosocial functioning in individuals with schizophrenia or schizoaffective disorder. Method: A systematic review was performed using the quality assessment criteria defined by Scottish Intercollegiate Guidelines Network (SIGN 50) to investigate the effects of CACR on clinical symptoms in individuals with a diagnosis of schizophrenia or schizoaffective disorder. Additionally, a within subjects repeated measures design was used to investigate the effects of CACR on cognitive functioning, functional capacity and everyday social functioning. Results: There was some evidence to suggest that CACR improves clinical symptoms, but the majority of studies reviewed did not report a significant effect, and a number of methodological weaknesses were identified in the literature. Results of the experimental study revealed improvements in speed of processing, reasoning and problem solving and the overall composite score for cognition, but these improvements could not be attributed solely to the CACR intervention. No improvements in functional capacity or everyday social functioning were observed. Conclusions: Further, more rigorous research is required to develop a clearer understanding of the effects of CACR on clinical symptoms. The results of the experimental study support previous literature which has identified that a pure CACR intervention does not improve psychosocial functioning. The results are discussed in relation to the relevant literature.