Acceptability, engagement, and efficacy of cognitive remediation for cognitive outcomes in young adults with first-episode psychosis and social anxiety: A randomized-controlled trial.

Psychiatry Res

Prevention and Early Intervention Program for Psychoses, Douglas Mental Health University Institute, Montreal, 6875 Bd LaSalle, Verdun, Quebec, H4H 1R3, Canada; Department of Psychiatry, McGill University, Ludmer Research & Training Building, 1033 Pine Avenue West, Montreal, Quebec, H3A 1A1, Canada. Electronic address:

Published: December 2024

AI Article Synopsis

  • Social anxiety disorder (SAD) often occurs alongside first-episode psychosis (FEP), which can worsen cognitive issues; this study investigates whether group cognitive remediation (CR) is more effective than group cognitive-behavioral therapy (CBT) for improving cognition in FEP+SAD patients.
  • Participants with FEP+SAD were divided into two groups, receiving either CR or CBT, and their cognitive performance was measured at various points, showing significant improvement in executive functions and visual memory for those in the CR group.
  • While 44% of participants completed the CR sessions, the study found challenges in engagement and acceptability, suggesting the need for future research to enhance participation in CR programs.

Article Abstract

Social anxiety disorder (SAD) is a frequent comorbidity in first-episode psychosis (FEP) and may increase cognitive impairments. Cognitive remediation (CR) is an effective treatment for cognition, particularly in a group format. This study aims to assess the efficacy, acceptability and engagement of group CR on cognitive outcomes in FEP+SAD compared to group cognitive-behavioral therapy (CBT). Participants with FEP+SAD were randomized to group CR (n = 45) or CBT-SAD (n = 51). They were assessed for cognition at baseline, post-therapy and 3- and 6-month follow-up. The CR group additionally completed scale to assess perceived competency and enjoyment in CR. Linear mixed models for repeated measures were used for cognitive scores. Descriptive statistics and t-tests were used to summarize acceptability, perceived competency, and enjoyment, for CR completers and non-completers. The CR group performed significantly better than CBT on executive functions and visual memory at post-therapy compared to baseline. Twenty participants completed CR (44 %; mean 5.5 sessions). At week 1, CR non-completers presented higher levels of perceived competency. Completers reported higher enjoyment scores at the last session compared to the first session. Group CR is effective for cognitive outcomes in FEP+SAD, but acceptability and engagement present a challenge. Future studies are necessary to explore approaches promoting engagement.

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Source
http://dx.doi.org/10.1016/j.psychres.2024.116243DOI Listing

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