Background:
This study assessed the effectiveness of computer-assisted cognitive remediation in the treatment of cognitive deficits in people with both recent onset schizophrenia and chronic schizophrenia.
Methods:
A randomized wait-list control study was conducted over eight sites using Medalia's Neuro-psychological Approach to Remediation (NEAR). All subjects were diagnosed with schizophrenia or schizoaffective disorder and were recruited from a range of community and in-patient facilities. Subjects were randomized between an immediate treatment and a waitlist group, the later being treated after 15 weeks. Subjects were assessed at baseline, after at least 20 sessions of NEAR and 15 weeks after the completion of treatment on measures of symptomatology, function and neurocognition.
Results:
Minimal differences were observed between waitlist and immediate treatment groups at baseline. However subjects with chronic schizophrenia were rated significantly higher for positive and total symptoms on the Positive and Negative Syndrome Scale. After treatment, significant improvements were observed for attention, processing speed and a limited range of executive functions. Improvements were accompanied by an improvement in social and occupational functioning particularly for subjects with recent onset disease. There were few changes in levels of symptomatology, self-esteem or quality of life.
Conclusions:
This study supports the effectiveness of computer-assisted cognitive remediation in both recent onset and chronic schizophrenia in treating the cognitive deficits of schizophrenia. This appeared to have a social and occupational impact for young people with recent onset disease.
