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Computer-assisted cognitive remediation in adolescents with psychosis or at risk for psychosis: a 6-month follow-up

Published online by Cambridge University Press:  24 June 2014

Sébastien Urben ,
Sandrine Pihet ,
Laure Jaugey ,
Olivier Halfon  and
Laurent Holzer
Sébastien Urben*
Affiliation:
Research Unit, University Service of Child and Adolescent Psychiatry, Lausanne, Switzerland
Sandrine Pihet
Affiliation:
Research Unit, University Service of Child and Adolescent Psychiatry, Lausanne, Switzerland
Laure Jaugey
Affiliation:
Day Care Unit for Adolescents (DCUA), University Service of Child and Adolescent Psychiatry, Lausanne, Switzerland
Olivier Halfon
Affiliation:
University Service of Child and Adolescent Psychiatry, Lausanne, Switzerland
Laurent Holzer
Affiliation:
Day Care Unit for Adolescents (DCUA), University Service of Child and Adolescent Psychiatry, Lausanne, Switzerland
*
Sébastien Urben, Research Unit, University Service of Child and Adolescent Psychiatry, Route du Bugnon 25A, 1011 Lausanne, Switzerland. Tel: +41 21 3147493; Fax: +41 21 3147481; E-mail: Sebastien.Urben@chuv.ch
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Extract

Urben S, Pihet S, Jaugey L, Halfon O, Holzer L. Computer-assisted cognitive remediation in adolescents with psychosis or at risk for psychosis: a 6-month follow-up.

Objective: To investigate short-term outcomes of a computer-assisted cognitive remediation (CACR) for adolescents with psychotic disorders or at high risk for psychosis.

Method: Cognitive abilities and clinical status were assessed at baseline (N = 32) and at 6-month follow-up (N = 22) after enrolment in either a CACR (treatment group) or a computer games (control group) program (8 weeks).

Results: With regard to the cognitive abilities, no amelioration was found in the control group while, in the CACR group, significant improvements in inhibition (p = 0.040) and reasoning (p = 0.005) were observed. Furthermore, symptom severity decreased significantly in the control group (p = 0.046) and marginally in the CACR group (p = 0.088). Improvements in cognitive abilities were not associated with symptoms' amelioration. Finally, increase in reasoning abilities was related to the median effective work time in sessions of CACR (R = 0.64, p = 0.024).

Conclusion: At follow-up, enhanced cognitive abilities (reasoning and inhibition), which are necessary for executing higher-order goals or adapting behaviour to the ever-changing environment, were reported in adolescents participants of the CACR. Thus, further studies are needed to confirm and extend these interesting results.

Keywords

adolescentscognitive remediationneuropsychologypsychoses
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 24 , Issue 6 , December 2012 , pp. 328 - 335
Copyright
Copyright © Cambridge University Press 2012

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References

1.Asarnow, RF, Asamen, J, Granholm, E, Sherman, T, Watkins, JM, Williams, ME.Cognitive/neuropsychological studies of children with a schizophrenic disorder. Schizophr Bull 1994;20:647–669.CrossRefGoogle ScholarPubMed
2.Holzer, L, Chinet, L, Jaugey, L et al. Detection of cognitive impairment with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) in adolescents with psychotic symptomatology. Schizophr Res 2007;95:48–53.CrossRefGoogle ScholarPubMed
3.Kenny, JT, Friedman, L, Findling, RL et al. Cognitive impairment in adolescents with schizophrenia. Am J Psychiatry 1997;154:1613–1615.CrossRefGoogle ScholarPubMed
4.Kumra, S, Wiggs, E, Bedwell, J et al. Neuropsychological deficits in pediatric patients with childhood-onset schizophrenia and psychotic disorder not otherwise specified. Schizophr Res 2000;42:135–144.CrossRefGoogle Scholar
5.Rhinewine, JP, Lencz, T, Thaden, EP et al. Neurocognitive profile in adolescents with early-onset schizophrenia: clinical correlates. Biol Psychiatry 2005;58:705–712.CrossRefGoogle ScholarPubMed
6.Schulz, SC, Findling, RL, Friedman, L, Kenny, JT, Wise, AL.Treatment and outcomes in adolescents with schizophrenia. J Clin Psychiatry 1998;59(Suppl. 1):50–54.Google ScholarPubMed
7.Bark, N, Revheim, N, Huq, F, Khalderov, V, Ganz, ZW, Medalia, A.The impact of cognitive remediation on psychiatric symptoms of schizophrenia. Schizophr Res 2003;63:229–235.CrossRefGoogle ScholarPubMed
8.Wykes, T, Newton, E, Landau, S, Rice, C, Thompson, N, Frangou, S.Cognitive remediation therapy (CRT) for young early onset patients with schizophrenia: an exploratory randomized controlled trial. Schizophr Res 2007;94:221–230.CrossRefGoogle ScholarPubMed
9.Fuller, R, Nopoulos, P, Arndt, S, O'Leary, D, Ho, BC, Andreasen, NC.Longitudinal assessment of premorbid cognitive functioning in patients with schizophrenia through examination of standardized scholastic test performance. Am J Psychiatry 2002;159:1183–1189.CrossRefGoogle ScholarPubMed
10.Nieuwenstein, MR, Aleman, A, de Haan, EH.Relationship between symptom dimensions and neurocognitive functioning in schizophrenia: a meta-analysis of WCST and CPT studies. Wisconsin Card Sorting Test. Continuous Performance Test. J Psychiatr Res 2001;35:119–125.CrossRefGoogle ScholarPubMed
11.Medalia, A, Revheim, N, Casey, M.Remediation of memory disorders in schizophrenia. Psychol Med 2000;30: 1451–1459.CrossRefGoogle ScholarPubMed
12.Bhatia, T, Agarwal, A, SHaah, G et al. Adjunctive cognitive remediation for schizophrenia using yoga: an open, non-randomised trial. Acta Neuropsychiatrica (in press).Google Scholar
13.Krabbendam, L, Aleman, A.Cognitive rehabilitation in schizophrenia: a quantitative analysis of controlled studies. Psychopharmacology (Berl) 2003;169:376–382.CrossRefGoogle ScholarPubMed
14.Kurtz, MM, Moberg, PJ, Gur, RC, Gur, RE.Approaches to cognitive remediation of neuropsychological deficits in schizophrenia: a review and meta-analysis. Neuropsychol Rev 2001;11:197–210.CrossRefGoogle ScholarPubMed
15.Pilling, S, Bebbington, P, Kuipers, E et al. Psychological treatments in schizophrenia: II. Meta-analyses of randomized controlled trials of social skills training and cognitive remediation. Psychol Med 2002;32:783–791.CrossRefGoogle ScholarPubMed
16.Twamley, EW, Jeste, DV, Bellack, AS.A review of cognitive training in schizophrenia. Schizophr Bull 2003;29: 359–382.CrossRefGoogle ScholarPubMed
17.McGurk, SR, Twamley, EW, Sitzer, DI, McHugo, GJ, Mueser, KT.A meta-analysis of cognitive remediation in schizophrenia. Am J Psychiatry 2007;164:791–802.CrossRefGoogle ScholarPubMed
18.Wykes, T, Huddy, V, Cellard, C, McGurk, SR, Czobor, P.A meta-analysis of cognitive remediation for schizophrenia: methodology and effect sizes. Am J Psychiatry 2011;168:472–485.CrossRefGoogle ScholarPubMed
19.Bell, M, Bryson, G, Wexler, BE.Cognitive remediation of working memory deficits: durability of training effects in severely impaired and less severely impaired schizophrenia. Acta Psychiatr Scand 2003;108:101–109.CrossRefGoogle ScholarPubMed
20.Medalia, A, Revheim, N, Casey, M.Remediation of problem-solving skills in schizophrenia: evidence of a persistent effect. Schizophr Res 2002;57:165–171.CrossRefGoogle ScholarPubMed
21.Ueland, T, Rund, BR.A controlled randomized treatment study: the effects of a cognitive remediation program on adolescents with early onset psychosis. Acta Psychiatr Scand 2004;109:70–74.CrossRefGoogle Scholar
22.Ueland, T, Rund, BR.Cognitive remediation for adolescents with early onset psychosis: a 1-year follow-up study. Acta Psychiatr Scand 2005;111:193–201.CrossRefGoogle ScholarPubMed
23.Wykes, T, Reeder, C, Landau, S et al. Cognitive remediation therapy in schizophrenia: randomised controlled trial. Br J Psychiatry 2007;190:421–427.CrossRefGoogle ScholarPubMed
24.Medalia, A, Aluma, M, Tryon, W, Merriam, AE.Effectiveness of attention training in schizophrenia. Schizophr Bull 1998;24:147–152.CrossRefGoogle ScholarPubMed
25.Bremer, J, Rauch, PK.Children and computers: risks and benefits. J Am Acad Child Adolesc Psychiatry 1998;37:559–560.CrossRefGoogle ScholarPubMed
26.Kurtz, MM, Seltzer, JC, Shagan, DS, Thime, WR, Wexler, BE.Computer-assisted cognitive remediation in schizophrenia: what is the active ingredient? Schizophr Res 2007;89:251–260.CrossRefGoogle ScholarPubMed
27.Hogarty, GE, Flesher, S, Ulrich, R et al. Cognitive enhancement therapy for schizophrenia: effects of a 2-year randomized trial on cognition and behavior. Arch Gen Psychiatry 2004;61:866–876.CrossRefGoogle ScholarPubMed
28.Bellucci, DM, Glaberman, K, Haslam, N.Computer-assisted cognitive rehabilitation reduces negative symptoms in the severely mentally ill. Schizophr Res 2003;59:225–232.CrossRefGoogle ScholarPubMed
29.Burda, PC, Starkey, TW, Dominguez, F, Vera, V.Computer-assisted cognitive rehabilitation of chronic psy chiatric-inpatients. Comput Human Behav 1994;10:359–368.CrossRefGoogle Scholar
30.Fisher, M, Holland, C, Merzenich, MM, Vinogradov, S.Using neuroplasticity-based auditory training to improve verbal memory in schizophrenia. Am J Psychiatry 2009;166: 805–811.CrossRefGoogle ScholarPubMed
31.Medalia, A, Aluma, M, Tryon, W, Merriam, AE.Effectiveness of attention training in schizophrenia. Schizophr Bull 1998;24:147–152.CrossRefGoogle ScholarPubMed
32.Grynszpan, O, Perbal, S, Pelissolo, A et al. Efficacy and specificity of computer-assisted cognitive remediation in schizophrenia: a meta-analytical study. Psychol Med 2011;41:163–173.CrossRefGoogle ScholarPubMed
33.Holzer, L, Passini, MC, Pellanda, V et al. A randomised controlled trial of the effectiveness of a computer-assisted cognitive remediation (CACR) program in adolescents with psychosis or at high risk of psychosis. Behav Res Ther (submitted).Google Scholar
34.APA. Diagnostic and statistical manual of mental disorders (DSM-IV), 4th edn. Washington (DC): American Psychiatric Association, 1994.Google Scholar
35.Nurnberger, JI, Blehar, MC, Kaufmann, CA et al. Diagnostic interview for genetic-studies - rationale, unique features, and training. Arch Gen Psychiatry 1994;51:849–859.CrossRefGoogle ScholarPubMed
36.Preisig, M, Fenton, BT, Matthey, ML, Berney, A, Ferrero, F.Diagnostic interview for genetic studies (DIGS): inter-rater and test-retest reliability of the French version. Eur Arch Psychiatry Clin Neurosci 1999;249:174–179.CrossRefGoogle ScholarPubMed
37.Miller, TJ, McGlashan, TH, Woods, SW et al. Symptom assessment in schizophrenic prodromal states. Psychiatr Q 1999;70:273–287.CrossRefGoogle ScholarPubMed
38.Randolph, C, Tierney, MC, Mohr, E, Chase, TN.The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS): preliminary clinical validity. J Clin Exp Neuropsychol 1998;20:310–319.CrossRefGoogle ScholarPubMed
39.Mackinnon, A, Mulligan, R.The estimation of premorbid intelligence levels in French speakers. Encephale 2005;31:31–43.CrossRefGoogle ScholarPubMed
40.Sanford, JA, Brown, RJ.Captain's log cognitive system. Richmond: Brain Train, Inc., 1988.Google Scholar
41.Wechsler, D.WAIS III: Echelle d'intelligence pour adultes, 3ème. Paris: ECPA, 1997.Google Scholar
42.Wechsler, D.WISC IV: Echelle d'intelligence pour enfants, 4ème. Paris: ECPA, 2005.Google Scholar
43.Wechsler, D.MEM III: Echelle clinique de mémoire de Wechsler, 3ème. Paris: ECPA, 1997.Google Scholar
44.Brandt, J.The Hopkins Verbal Learning Test: development of a new verbal memory test with six equivalent forms. Clin Neuropsychol 2005;5:125–142.CrossRefGoogle Scholar
45.Benedict, RHB, Schretlen, D, Groninger, L, Dobraski, M, Shpritz, B.Revision of the brief visuospatial memory test: studies of normal performance, reliability, and validity. Psychol Assess 1996;8:145–153.CrossRefGoogle Scholar
46.Stroop, JR.Studies of interference in serial verbal reactions. J Exp Psychol 1935;18:643–662.CrossRefGoogle Scholar
47.Sauzeon, H, Lestage, P, Raboutet, C, N'Kaoua, B, Claverie, B.Verbal fluency output in children aged 7-16 as a function of the production criterion: qualitative analysis of clustering, switching processes, and semantic network exploitation. Brain Lang 2004;89:192–202.CrossRefGoogle ScholarPubMed
48.Krikorian, R, Bartok, J, Gay, N.Tower of London procedure: a standard method and developmental data. J Clin Exp Neuropsychol 1994;16:840–850.CrossRefGoogle Scholar
49.Guy, W.ECDEU assessment manual. Rockville (Maryland): US Department of Health, Education and Welfare, 1976.CrossRefGoogle Scholar
50.Miyake, A, Friedman, NP, Emerson, MJ, Witzki, AH, Howerter, A, Wager, TD.The unity and diversity of executive functions and their contributions to complex “Frontal Lobe” tasks: a latent variable analysis. Cogn Psychol 2000;41:49–100.CrossRefGoogle ScholarPubMed
51.Logan, GD. On the ability to inhibit thought and action: a users' guide to the stop signal paradigm. In: Dagenbach, D, Carr, TH, eds. Inhibitory processes in attention, memory, and language. London: Academic Press Inc., 1994: 189–239.Google Scholar
52.Huizenga, HM, Crone, EA, Jansen, BJ.Decision-making in healthy children, adolescents and adults explained by the use of increasingly complex proportional reasoning rules. Dev Sci 2007;10:814–825.CrossRefGoogle ScholarPubMed
53.Bechara, A, Damasio, AR, Damasio, H, Anderson, SW.Insensitivity to future consequences following damage to human prefrontal cortex. Cognition 1994;50:7–15.CrossRefGoogle ScholarPubMed