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Combined social cognitive and neurocognitive rehabilitation strategies in schizophrenia: neuropsychological and psychopathological influences on Theory of Mind improvement

Published online by Cambridge University Press:  11 June 2015

M. Bechi ,
M. Bosia ,
M. Spangaro ,
M. Buonocore ,
F. Cocchi ,
A. Pigoni ,
M. Piantanida ,
C. Guglielmino ,
L. Bianchi  and
E. Smeraldi
...Show all authors
M. Bechi*
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
M. Bosia
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy Università Vita - Salute San Raffaele, Milan, Italy
M. Spangaro
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy Università Vita - Salute San Raffaele, Milan, Italy
M. Buonocore
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
F. Cocchi
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
A. Pigoni
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
M. Piantanida
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
C. Guglielmino
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
L. Bianchi
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
E. Smeraldi
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy Università Vita - Salute San Raffaele, Milan, Italy
R. Cavallaro
Affiliation:
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
*
*Address for correspondence: Dr M. Bechi, Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127 Milano, Italy. (Email: [email protected])
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Abstract

Background

Neurocognitive and social cognitive impairments represent important treatment targets in schizophrenia, as they are significant predictors of functional outcome. Different rehabilitative interventions have recently been developed, addressing both cognitive and psychosocial domains. Although promising, results are still heterogeneous and predictors of treatment outcome are not yet identified. In this study we evaluated the efficacy of two newly developed social cognitive interventions, respectively based on the use of videotaped material and comic strips, combined with domain-specific Cognitive Remediation Therapy (CRT). We also analysed possible predictors of training outcome, including basal neurocognitive performance, the degree of cognitive improvement after CRT and psychopathological variables.

Method

Seventy-five patients with schizophrenia treated with CRT, were randomly assigned to: social cognitive training (SCT) group, Theory of Mind Intervention (ToMI) group, and active control group (ACG).

Results

ANOVAs showed that SCT and ToMI groups improved significantly in ToM measures, whereas the ACG did not. We reported no influences of neuropsychological measures and improvement after CRT on changes in ToM. Both paranoid and non-paranoid subjects improved significantly after ToMI and SCT, without differences between groups, despite the better performance in basal ToM found among paranoid patients. In the ACG only non-paranoid patients showed an improvement in non-verbal ToM.

Conclusion

Results showed that both ToMI and SCT are effective in improving ToM in schizophrenia with no influence of neuropsychological domains. Our data also suggest that paranoid symptoms may discriminate between different types of ToM difficulties in schizophrenia.

Keywords

Neurocognitionparanoiarehabilitationschizophreniasocial cognitionTheory of Mind
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 15 , November 2015 , pp. 3147 - 3157
Copyright
Copyright © Cambridge University Press 2015 

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