scholarly journals Cognitive, creative, functional, and clinical symptom improvements in schizophrenia after an integrative cognitive remediation program: a randomized controlled trial

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Agurne Sampedro ◽  
Javier Peña ◽  
Pedro Sánchez ◽  
Naroa Ibarretxe-Bilbao ◽  
Ainara Gómez-Gastiasoro ◽  
...  

AbstractThis study analyzed the effectiveness of an integrative cognitive remediation program (REHACOP) in improving neurocognition, social cognition, creativity, functional outcome, and clinical symptoms in patients with schizophrenia. In addition, possible mediators predicting improvement in functional outcomes were explored. The program combined cognitive remediation with social cognitive training and social and functional skill training over 20 weeks. The sample included 94 patients, 47 in the REHACOP group and 47 in the active control group (occupational activities). Significant differences were found between the two groups in change scores of processing speed, working memory, verbal memory (VM), inhibition, theory of mind, emotion processing (EP), figural creative strengths, functional competence, disorganization, excitement, and primary negative symptoms. A mediational analysis revealed that changes in VM, inhibition, and EP partially explained the effect of cognitive remediation on functional competence improvement. This study provides initial evidence of the effect of integrative cognitive remediation on primary negative symptoms and creativity.

2019 ◽  
Vol 8 ◽  
Author(s):  
Maedeh Parvizi ◽  
Farbod Fadai ◽  
Moahammad Reza Khodaei-Ardakani ◽  
Gholamreza Amin ◽  
Leila Abdi ◽  
...  

Background: Cuscuta epithymum (CE) is an established medicinal herb utilized for treating psychosis in Persian medicine. The aim of this study was to investigate the effect of CE combined with risperidone on the clinical symptoms and the cognitive impairment in patients diagnosed with schizophrenia. Materials and Methods: In this triple-blind randomized placebo-controlled trial, the intervention group received a dose of 500 mg of CE in the form of a capsule to be taken twice a day accompanied by an appropriate dose of risperidone. The control group was presented with a placebo identical to that of the CE capsule plus the allocated dose of risperidone. The PANSS and SCoRS questionnaires were used to assess the status of subjects prior to the initiation of the intervention as well as being put to use at the end of the second, fourth, and eighth week post-intervention. Registering and recording intel concerning positive and negative symptoms felt by participants (PANNS), and a test to assess the cognitive impairment of the individuals. Results: After eight weeks of treatment, all negative and positive symptoms besides hostility and somatic concern exhibited a significant improvement in the CE group (P <0.05). In contrast, the CE placebo group displayed no substantial improvement in the cases of the positive, negative and general symptoms (P>0.05) regarding cognitive impairment, after eight weeks of treatment, all symptoms were greatly improved in the CE group (P<0.05), while the effect of the placebo  on the patients cognitive impairment remained mostly stationary (P>0.05). Consequently, after eight weeks after the intervention, we can determine that the CE treatment has been noticeably more effective at improving positive, negative and cognitive symptoms of patients with schizophrenia. Conclusion: The results of this study demonstrated that CE, possessing possible antioxidant and neuroprotective properties, safely improved the positive and negative symptoms, and cognitive impairment of patients with schizophrenia.[GMJ.2019;8:e1334]


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S610-S610
Author(s):  
Amber Watts ◽  
Eric Vidoni ◽  
Jill Morris ◽  
Mark Perry ◽  
David Johnson ◽  
...  

Abstract Exercise is a promising strategy for prevention of Alzheimer’s disease (AD). Amyloid neuroimaging can identify individuals at risk of developing AD prior to displaying symptoms. We screened adults (65+) with Florbetapir PET imaging and a comprehensive cognitive battery. We randomized 117 participants with normal cognition into a 52-week aerobic exercise program to examine the effects of aerobic exercise on cognitive performance. We compared an intensive exercise treatment group to a standard of care control group. Cognition was assessed at baseline, 26 weeks, and 52 weeks in the domains of verbal memory, visuospatial processing, attention, and executive function. Interim results on 87 participants show cardiorespiratory fitness improved in the exercise group vs. control group (t=3.66(81), p&lt; .001). The degree of change in cardiorespiratory fitness did not differ between those with and without elevated amyloid (t=-0.37(81), p=.710). Greater improvements in cardiorespiratory fitness predicted better performance on cognitive tests including trailmaking test, Stroop test, and digit symbol substitution test, which did not differ by amyloid status. Elevated amyloid levels predicted lower cognitive scores in logical memory, space relations, and identical pictures test. Our findings suggest PET imaging is a valid marker of cognitive performance in non-impaired older adults, and that this pre-clinical amyloid status did not reduce the cognitive benefits of exercise for those who improved in cardiorespiratory fitness. Exercise interventions hold promise for cognitive maintenance among pre-symptomatic older adults with elevated amyloid levels. Finally, results highlight the importance of evaluating multiple cognitive domains which are associated differently with exercise and amyloid status.


2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 5-7
Author(s):  
R Khan ◽  
M A Scaffidi ◽  
N Gimpaya ◽  
D Tham ◽  
M Atalla ◽  
...  

Abstract Background Polypectomy is an essential endoscopic skill. Training in polypectomy has been identified as a major deficiency for endoscopists worldwide as polypectomy occurs ad hoc during a colonoscopy when a polyp is detected, and a lack of standardized curricula. Augmented reality (AR), which superimposes computer-generated images on a user’s view of the world, can address these gaps by standardizing encounters with polyps while completing simulated procedures and enabling polypectomy-specific teaching. Aims Evaluate the impact of a simulation-based augmented reality curriculum on polypectomy performance among novice endoscopists. Methods This study includes two cohorts of participants from 2019 to 2020. In 2019, participants were randomized into either: (1) a control curriculum, involving 6 hours of simulation-based training (SBT) supplemented by expert feedback, interlaced with 4 hours of small group teaching on the theory of colonoscopy; or (2) the augmented reality curriculum (ARC), in involving the same curriculum with integrated AR, wherein participants engaged with an AR-enhanced video demonstrating relevant therapeutic and pathologic details during polypectomy. The SBT for all participants involved a progressive curriculum starting on a bench-top model and then moving to the EndoVR® virtual reality simulator. The primary outcome was polypectomy-specific performance using the Direct Observation of Polypectomy Skills (DOPyS) tool during a simulated polypectomy after training, with a maximum score of 100. Results Demographic characteristics are summarized in Table. In 2019, 21 novice endoscopists were enrolled. Immediately after training, the mean DOPyS score among ARC group participants was 76.2 (SD=17.9) compared to 71.8 (SD=13.2) among control group participants (Figure). In this interim analysis, there was no significant difference between groups. Data analysis will be completed after 2020 participants complete the study. Conclusions Interim results show a trend towards improved polypectomy performance with no significant difference. The results of this study have the potential to impact polypectomy education among novices. Simulation-based AR interventions may allow learners to progress towards achieving competency in polypectomy in a risk-free environment prior to first patient contact. Funding Agencies None


2019 ◽  
Vol 49 (5) ◽  
pp. 1559-1573 ◽  
Author(s):  
Daniel Ventus ◽  
Annika Gunst ◽  
Stefan Arver ◽  
Cecilia Dhejne ◽  
Katarina G. Öberg ◽  
...  

AbstractPremature ejaculation (PE) is associated with decreased quality of life, lower confidence and self-esteem, and higher levels of depression, anxiety, and interpersonal difficulties. Here we investigated the effectiveness of vibrator-assisted start–stop exercises for treatment of PE, and whether the treatment effect could be enhanced by an additional psychobehavioral intervention. Fifty participants with a mean age of 41.7 years were included and randomized into two treatment groups and a waiting list control group. Participants were instructed to perform start–stop exercises while stimulating the penis with a purpose-made vibrator, 3 times a week for 6 weeks. Additionally, participants in one of the treatment groups received additional psychoeducation and performed mindfulness meditation-based body scan exercises three times a week. Data were gathered through online questionnaires before and after treatment, as well as 3 and 6 months after treatment. The interventions reduced PE symptoms with large effect sizes (partial η2 = .20 across the three groups, d [95% CI] = 1.05 [.27, 1.82] and 1.07 [.32, 1.82] for treatment groups compared to waiting list control group). The additional psychobehavioral intervention did not further reduce PE symptoms, but did decrease PE-associated negative symptoms such as levels of sexual distress, anxiety, and depression. No side effects were reported. Vibrator-assisted start–stop exercises can be offered as an adequate treatment option for PE.


2015 ◽  
Vol 45 (15) ◽  
pp. 3147-3157 ◽  
Author(s):  
M. Bechi ◽  
M. Bosia ◽  
M. Spangaro ◽  
M. Buonocore ◽  
F. Cocchi ◽  
...  

BackgroundNeurocognitive 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.MethodSeventy-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).ResultsANOVAs 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.ConclusionResults 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.


1994 ◽  
Vol 24 (4) ◽  
pp. 869-884 ◽  
Author(s):  
B. Schmand ◽  
T. Kuipers ◽  
M. Van Der Gaag ◽  
J. Bosveld ◽  
F. Bulthuis ◽  
...  

SynopsisThe problem of a possible lack of motivation to perform cognitive tasks, which is often encountered in psychotic patients, has been approached from the perspective of the ‘energetics’ of cognition (Hockey et al. 1986) and from the broader clinical context of psychosis as an ‘amotivational syndrome’ and its related negative symptoms.The presence of motivational deficits was investigated in a group of psychotic in-patients (N = 73, and 40 had schizophrenia) compared with a control group of non-psychotic psychiatric in-patients (N = 23). The motivational deficit was operationalized in terms of Sanders's (1983) cognitive–energetic model as a large effect of ‘time-on-task’ during a simple, monotonous reaction test. Significantly more psychotic patients than control patients showed evidence of this type of motivational deficit. The deficit appeared to be related with negative but not with positive symptoms of psychosis. Furthermore, the deficit was shown to be related to the cognitive disorders of psychosis, which have been amply documented in the literature, i.e. disorders of vigilance, verbal memory and distractibility. These results suggest that the cognitive disorders of psychosis are not of a ‘computational’ but of an ‘energetical’, i.e. motivational nature.


2020 ◽  
Author(s):  
Ziyan Li ◽  
Yanzhe Ning ◽  
Pei Chen ◽  
Yi Zhang ◽  
Dongqing Yin ◽  
...  

Abstract BackgroundAt present, the focus and difficulty of schizophrenia (SCZ) treatment is to improve cognitive function and negative symptoms. Jie-du-qing-nao granules(JQG) , a traditional Chinese medicine(TCM) prescription , has a good clinical effectiveness in enhancing the cognition and negative symptoms of patients with SCZ. However, its clear effectiveness and safety have not been adequately supported by clinical studies. The main objective of this study is to explore the efficacy and safety of JQG for first-episode schizophrenics.Methods/designThis trial is a prospective, randomized, single-centered, parallel-controlled clinical study with double-blind design. A total of 96 eligible participants will be randomly assigned to either the study group or the control group in a ratio of 1:1. Participants allocated to the study group will receive JQG and aripiprazole, control group will receive placebo and aripiprazole. The treatment course will last 12 weeks, with follow-up every 4 weeks. Outcome measurements include Positive and Negative Syndrome Scale (PANSS), self face test , MATRICS Consensus Cognitive Battery (MCCB), TNFα, IL-6, IL-1β, BDNF, vital signs, complete blood count, liver and kidney function tests, urinalysis, and electrocardiograph. Adverse reactions will be evaluated using the Treatment Emergent Symptom Scale (TESS).DiscussionThis study will provide evidence for the efficacy and safety of JQG as a complementary approach, which can be initiated following with antipsychotics therapy. Trial registration Chinese Clinical Trial Registry, ID: ChiCTR1900028250 . Registered on December 16, 2019, http://www.chictr.org.cn/edit.aspx?pid=41880&htm=4 .


JMIR Nursing ◽  
10.2196/20747 ◽  
2020 ◽  
Vol 3 (1) ◽  
pp. e20747
Author(s):  
Mahboube Davoudi ◽  
Tahereh Najafi Ghezeljeh ◽  
Farveh Vakilian Aghouee

Background Patients with heart failure have low quality of life because of physical impairments and advanced clinical symptoms. One of the main goals of caring for patients with heart failure is to improve their quality of life. Objective The aim of this study was to investigate the effect of the use of a smartphone-based app on the quality of life of patients with heart failure. Methods This randomized controlled clinical trial with a control group was conducted from June to October 2018 in an urban hospital. In this study, 120 patients with heart failure hospitalized in cardiac care units were randomly allocated to control and intervention groups. Besides routine care, patients in the intervention group received a smartphone-based app and used it every day for 3 months. Both the groups completed the Minnesota Living with Heart Failure Questionnaire before entering the study and at 3 months after entering the study. Data were analyzed using the SPSS software V.16. Results The groups showed statistically significant differences in the mean scores of quality of life and its dimensions after the intervention, thereby indicating a better quality of life in the intervention group (P<.001). The effect size of the intervention on the quality of life was 1.85 (95% CI 1.41-2.3). Moreover, the groups showed statistically significant differences in the changes in the quality of life scores and its dimensions (P<.001). Conclusions Use of a smartphone-based app can improve the quality of life in patients with heart failure. The results of our study recommend that digital apps be used for improving the management of patients with heart failure. Trial Registration Iranian Registry of Clinical Trials IRCT2017061934647N1; https://www.irct.ir/trial/26434


2004 ◽  
Vol 9 (2) ◽  
pp. 96-106 ◽  
Author(s):  
Bernhard W. Müller ◽  
Gudrun Sartory ◽  
Stefan Bender

The most frequently reported neuropsychological deficits in schizophrenia are those of attention, executive function, and verbal memory. Whereas the former appear to be related to negative symptoms of schizophrenia, there is little agreement about which clinical symptoms are related to the verbal memory deficit. The aim of the present study was to delineate further the pattern of neuropsychological deficits in schizophrenia—especially those of verbal memory—and their relationship to clinical symptoms. One hundred patients with chronic schizophrenia and 62 healthy control subjects took part in the study. Assessments of patients took place within the first 3 weeks after admission to hospital. Nine neuropsychological tests, mainly measuring executive and memory function and attention, were administered to all subjects, and clinical symptoms, such as psychotic and negative symptoms and conceptual disorganization, were assessed in patients by means of the Positive and Negative Syndrome Scale (PANSS). Patients showed widespread cognitive deficits with verbal memory impairment best discriminating patients and controls. Conceptual disorganization was partly accounted for by poor verbal memory and a low IQ estimate, and negative symptoms by deficient word fluency; positive symptoms were not significantly related to cognitive deficits. The results indicate that there is a specific relationship between neuropsychological deficits and the more chronic of the clinical symptoms.


2016 ◽  
Vol 74 (10) ◽  
pp. 823-828 ◽  
Author(s):  
Ying Yang ◽  
Xiaojing Cheng ◽  
Qingzhi Xu ◽  
Renjun Li ◽  
Zengxun Liu ◽  
...  

ABSTRACT Objective To evaluate the effect of maintenance modified electroconvulsive therapy (MECT) on schizophrenic patients. Methods From June 2012 to June 2014, 62 patients with schizophrenia, who had recovered from a successful course of acute MECT, were recruited. Thirty-one patients received maintenance MECT and risperidone, as the experimental group. Another 31 patients were enrolled in the control group, and received risperidone only. The effects on cognitive functions, clinical symptoms and relapse rate were determined. Results Patients in the experimental group had a lower relapse rate and longer relapse-free survival time than the controls. Relative to the baseline evaluation, patients showed statistically significant improvement in verbal memory and visual memory. At the final assessment, the scores of verbal and visual memory were remarkably lower in the experimental group than the controls but there was no significant difference in other tests. Conclusion Maintenance MECT plus medication is superior to medication alone in preventing relapse and improving cognitive function.


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