COGNITIVE REMEDIATION THERAPY APPLIED TO PSYCHIATRIC PATIENTS: AN EXPERIMENTAL STUDY

Autores/as

  • Alessandra Sara Accetta Department of Biomedical, Dental Sciences and Morphofunctional Imagin, University of Messina; Psychiatric unit Policlinico, Italy https://orcid.org/0009-0002-5675-4322
  • Federica Arena Department of Biomedical, Dental Sciences and Morphofunctional Imagin, University of Messina; Psychiatric unit Policlinico, Italy
  • Cristina Bartolotta Psy. D. University of Messina, Italy
  • Chiara Galletta Psy. D. University of Messina, Italy
  • Claudia Scaramuzzino Department "Scienze della Salute", University of "Magna Graecia" of Catanzaro, Italy https://orcid.org/0009-0001-2021-7376

DOI:

https://doi.org/10.13129/3035-1383/asmc-5281

Palabras clave:

Neuropsychology, cognitive rehabilitation, executive functions, schizophrenia, bipolar disorder

Resumen

Cognitive Remediation Therapy (CRT) is an evidence-based rehabilitative intervention aimed at improving cognitive functions impaired in major psychiatric disorders, promoting the generalization of acquired skills to daily life contexts and supporting psychosocial functioning recovery. The aim of this study is to assess the effectiveness of Cognitive Remediation Therapy (CRT) as an integrated rehabilitative intervention for major psychiatric disorders, with a particular focus on schizophrenia and bipolar disorder. Background: In psychotic and bipolar disorders, cognitive deficits are one of the main factors that limit daily and psychosocial functioning, often persisting even after symptoms have remitted. In this context, Cognitive Remediation Therapy (CRT) has established itself as an evidence-based intervention aimed at enhancing cognitive functions and promoting functional recovery. Method: Two patients with different diagnoses (schizophrenia and bipolar disorder) underwent an individual CRT program consisting of 40 sessions. The protocol, organized into modules dedicated to cognitive flexibility, working memory, and planning, employed techniques such as errorless learning, scaffolding, verbalization, and positive reinforcement. Neuropsychological assessment, conducted using the ENB-2 battery before and after treatment, allowed for monitoring changes in the main cognitive domains. Results: Both patients demonstrated improvements in attentional, memory, and executive performance, accompanied by increased illness awareness, motivation, and perceived self-efficacy. Progress was also observed in relational functioning and autonomy in managing daily activities. Conclusion: The results confirm the effectiveness of Cognitive Remediation Therapy as a rehabilitative tool supporting cognitive and psychosocial recovery in psychotic and mood disorders. Integrating CRT into multidisciplinary treatment programs represents a valuable approach to promoting functional recovery and enhancing patients’ quality of life.

Referencias

Ahmed, A. O. (2020). Cognitive remediation for schizophrenia. Focus, 18(4), 436–439.

Amodio, D. M., & Frith, C. D. (2016). Meeting of minds: The medial frontal cortex and social cognition. In Discovering the social mind (pp. 183–207).

Anthony, W. A. (2000). A recovery-oriented service system: Setting some system level standards. Psychiatric Rehabilitation Journal, 24(2), 159.

Ashcraft, L., & Anthony, W. A. (2005). The story of the transformation of a mental health agency to a recovery orientation. Behavioral Healthcare Tomorrow, 14(2), 12–21.

Barch, D. M., Bustillo, J., Gaebel, W., Gur, R., Heckers, S., Malaspina, D., ... & Carpenter, W. (2013). Logic and justification for dimensional assessment of symptoms and related clinical phenomena in psychosis: Relevance to DSM-5. Schizophrenia Research, 150(1), 15–20.

Bellack, A. S. (2006). Scientific and consumer models of recovery in schizophrenia: Concordance, contracts, and implications.

Bora, E., & Pantelis, C. (2013). Theory of mind impairments in first-episode psychosis, individuals at ultra-high risk for psychosis and in first-degree relatives of schizophrenia: Systematic review and meta-analysis. Schizophrenia Research, 144(1–3), 31–36.

Bortolato, B., Miskowiak, K. W., Köhler, C. A., Vieta, E., & Carvalho, A. F. (2015). Cognitive dysfunction in bipolar disorder and schizophrenia: A systematic review of meta-analyses. Neuropsychiatric Disease and Treatment, 3111–3125.

Bowie, C. R., Bell, M. D., Fiszdon, J. M., Johannesen, J. K., Lindenmayer, J.-P., McGurk, S. R., Medalia, A. A., Penadés, R., Saperstein, A. M., Twamley, E. W., et al. (2020). Cognitive remediation for schizophrenia: An expert working group white paper on core techniques. Schizophrenia Research, 215, 49–53.

Delahunty, A., & Morice, R. (1993). A training programme for the remediation of cognitive deficits in schizophrenia. Department of Health, Albury.

Delahunty, A., Reeder, C., Wykes, T., et al. (2011). Cognitive remediation therapy manual (2nd ed.). Kings College Institute of Psychiatry.

Frith, C. D., & Frith, U. (2007). Social cognition in humans. Current Biology, 17(16), R724–R732.

García-Casal, J. A., Loizeau, A., Csipke, E., Franco-Martín, M., Perea-Bartolomé, M. V., & Orrell, M. (2016). Computer-based cognitive interventions for people living with dementia: A systematic literature review and meta-analysis. Aging & Mental Health, 21(5), 454–467. https://doi.org/10.1080/13607863.2015.1132677

Hedman, A. M., van Haren, N. E., van Baal, C. G., Kahn, R. S., & Pol, H. E. H. (2013). IQ change over time in schizophrenia and healthy individuals: A meta-analysis. Schizophrenia Research, 146(1–3), 201–208.

Hill, N. T., Mowszowski, L., Naismith, S. L., Chadwick, V. L., Valenzuela, M., & Lampit, A. (2017). Computerized cognitive training in older adults with mild cognitive impairment or dementia: A systematic review and meta-analysis. American Journal of Psychiatry, 174(4), 329–340.

Joyce, E. M., & Roiser, J. P. (2007). Cognitive heterogeneity in schizophrenia. Current Opinion in Psychiatry, 20, 268–272.

Judd, L. L., Akiskal, H. S., Zeller, P. J., Paulus, M., Leon, A. C., Maser, J. D., ... & Keller, M. B. (2000). Psychosocial disability during the long-term course of unipolar major depressive disorder. Archives of General Psychiatry, 57(4), 375–380.

Kim, E. J., Bahk, Y. C., Oh, H., Lee, W. H., Lee, J. S., & Choi, K. H. (2018). Current status of cognitive remediation for psychiatric disorders: A review. Frontiers in Psychiatry, 9, 461.

Kontis, D., Huddy, V., Reeder, C., Landau, S., & Wykes, T. (2013). Effects of age and cognitive reserve on cognitive remediation therapy outcome in patients with schizophrenia. The American Journal of Geriatric Psychiatry, 21(3), 218–230.

Li, W., Zhou, F. C., Zhang, L., Ng, C. H., Ungvari, G. S., Li, J., & Xiang, Y. T. (2020). Comparison of cognitive dysfunction between schizophrenia and bipolar disorder patients: A meta-analysis of comparative studies. Journal of Affective Disorders, 274, 652–661.

MacQueen, G. M., & Memedovich, K. A. (2017). Cognitive dysfunction in major depression and bipolar disorder: Assessment and treatment options. Psychiatry and Clinical Neurosciences, 71(1), 18–27.

McGurk, S. R., Twamley, E. W., Sitzer, D. I., McHugo, G. J., & Mueser, K. T. (2007). A meta-analysis of cognitive remediation in schizophrenia. American Journal of Psychiatry, 164(12), 1791–1802.

Milev, P., Ho, B. C., Arndt, S., & Andreasen, N. C. (2005). Predictive values of neurocognition and negative symptoms on functional outcome in schizophrenia: A longitudinal first-episode study with 7-year follow-up. American Journal of Psychiatry, 162(3), 495–506.

Mondini, S., Mapelli, D., Vestri, A., & Bisiacchi, P. S. (2003). Esame Neuropsicologico Breve 2. Raffaello Cortina.

Motter, J. N., Pimontel, M. A., Rindskopf, D., Devanand, D. P., Doraiswamy, P. M., & Sneed, J. R. (2016). Computerized cognitive training and functional recovery in major depressive disorder: A meta-analysis. Journal of Affective Disorders, 189, 184–191.

Pérez-Vigil, A., Ilzarbe, D., Garcia-Delgar, B., Morer, A., Pomares, M., Puig, O., ... & Lázaro, L. (2024). Theory of mind in neurodevelopmental disorders: Beyond autistic spectrum disorder. Neurología (English Edition), 39(2), 117–126.

Reichenberg, A., Harvey, P. D., Bowie, C. R., Mojtabai, R., Rabinowitz, J., Heaton, R. K., & Bromet, E. (2009). Neuropsychological function and dysfunction in schizophrenia and psychotic affective disorders. Schizophrenia Bulletin, 35(5), 1022–1029.

Sharma, T., & Antonova, L. (2003). Cognitive function in schizophrenia: Deficits, functional consequences, and future treatment. Psychiatric Clinics, 26(1), 25–40.

Szöke, A., Trandafir, A., Dupont, M. E., Meary, A., Schürhoff, F., & Leboyer, M. (2008). Longitudinal studies of cognition in schizophrenia: Meta-analysis. The British Journal of Psychiatry, 192(4), 248–257.

Wagner, H., & Bandeira, M. (2023). Effectiveness of cognitive remediation therapy in improving cognitive functioning in schizophrenia: A systematic review. Archives of Clinical Psychiatry, 50(2).

Watson, A. J., Harrison, L., Preti, A., Wykes, T., & Cella, M. (2022). Cognitive trajectories following onset of psychosis: A meta-analysis. The British Journal of Psychiatry, 221(6), 714–721.

Zemánková, P., Lošák, J., Czekóová, K., Lungu, O., Jáni, M., Kašpárek, T., & Bareš, M. (2018). Theory of mind skills are related to resting-state frontolimbic connectivity in schizophrenia. Brain Connectivity, 8(6), 350–361

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Publicado

2026-01-20

Número

Vol. 2 Núm. 2 (2025)

Sección

Assessment

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