Cognitive Remediation Therapy in Chronic Schizophrenia

2017 ◽  
pp. 292-307
Author(s):  
Susmita Halder ◽  
Akash Mahato
Keyword(s):  
Cognitive Deficits ◽  
Social Skills Training ◽  
Intervention Program ◽  
Cognitive Remediation ◽  
Chronic Schizophrenia ◽  
Skills Training ◽  
Psychotic Symptoms ◽  
Behavioral Management ◽  
Supportive Psychotherapy

Cognitive impairments are now recognized as one of the most ubiquitous features of schizophrenia. Cognitive deficits appear to play a large role in how patients with schizophrenia function in their everyday lives. The role of cognitive deficits in schizophrenia may be gauged by the fact that even when patients with schizophrenia are relatively free of psychotic symptoms, many still have extraordinary difficulty with communication, motivation, self-care, and establishing and maintaining relationships with others. Patients with schizophrenia are often additionally treated with supportive psychotherapy, behavioral management, or social skills training as required. However, the efficacy of these adjunct therapies could be limited in presence of marked cognitive deficits. Thus it becomes crucial to have specific intervention for the underlying cognitive deficits that appear detrimental to improvement of functioning of patients with schizophrenia. The present chapter focuses on cognitive training based intervention program for schizophrenia patients and its efficacy.

Cognitive Remediation Therapy in Chronic Schizophrenia

2021 ◽  
pp. 1337-1353
Author(s):  
Susmita Halder ◽  
Akash Mahato
Keyword(s):  
Cognitive Deficits ◽  
Social Skills Training ◽  
Intervention Program ◽  
Cognitive Remediation ◽  
Chronic Schizophrenia ◽  
Skills Training ◽  
Psychotic Symptoms ◽  
Behavioral Management ◽  
Supportive Psychotherapy

Cognitive impairments are now recognized as one of the most ubiquitous features of schizophrenia. Cognitive deficits appear to play a large role in how patients with schizophrenia function in their everyday lives. The role of cognitive deficits in schizophrenia may be gauged by the fact that even when patients with schizophrenia are relatively free of psychotic symptoms, many still have extraordinary difficulty with communication, motivation, self-care, and establishing and maintaining relationships with others. Patients with schizophrenia are often additionally treated with supportive psychotherapy, behavioral management, or social skills training as required. However, the efficacy of these adjunct therapies could be limited in presence of marked cognitive deficits. Thus it becomes crucial to have specific intervention for the underlying cognitive deficits that appear detrimental to improvement of functioning of patients with schizophrenia. The present chapter focuses on cognitive training based intervention program for schizophrenia patients and its efficacy.

New dopaminergic and non-dopaminergic theories in schizophrenia and their therapeutic impact

1997 ◽  
Vol 9 (2) ◽  
pp. 64-67
Author(s):  
R.S. Kahn
Keyword(s):  
Cognitive Deficits ◽  
Negative Symptoms ◽  
Dopamine Neurons ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
The Core ◽  
Schizophrenic Patients ◽  
Core Symptoms ◽  
Influential Theory

The dopamine (DA) hypothesis of schizophrenia, postulating that schizophrenia is characterized by increased dopamine function, has been the most influential theory on the pathogenesis of schizophrenia. It has recently been revised based on the appreciation that the core symptoms of schizophrenia may not be the positive (psychotic) symptoms, but rather the negative symptoms and the cognitive deficits found in schizophrenic patients. This revision has prompted the hypothesis that schizophrenia is characterized by both decreased prefrontal dopamine activity (causing deficit symptoms) and increased dopamine activity in mesolimbic dopamine neurons (causing positive symptoms).Notwithstanding this revision of a role for dopamine in schizophrenia, it has become increasingly evident that dysfunction of other monoaminergic systems may be as important in contributing to the pathophysiology of schizophrenia. Specifically, the putative role of serotonin (5-hydroxytryptamine, 5-HT) in schizophrenia is gaining considerable attention. Several observations, such as the ability of the 5-HT antagonist, ritanserin, to alleviate schizophrenic symptoms and, when added to haloperidol (Haldol®), to decrease its extrapyramidal side-effects (EPS), have stimulated studies into a role of 5-HT in schizophrenia. The finding that clozapine (Leponex®), clinically superior to conventional neuroleptics, is a weak DA2 antagonist but a potent 5-HT1c and 5-HT2 antagonist has further stimulated 5-HT-related research in schizophrenia.

Social skills vs. Neurocognitive training in psychotic patients

2011 ◽  
Vol 26 (S2) ◽  
pp. 1475-1475 ◽  
Author(s):  
G. Piegari ◽  
S. Galderisi ◽  
P. Bucci ◽  
A. Mucci ◽  
F. De Riso ◽  
...  
Keyword(s):  
Social Skills ◽  
Functional Outcome ◽  
Social Skills Training ◽  
Synergistic Effects ◽  
Combined Treatment ◽  
Critical Evaluation ◽  
Cognitive Remediation ◽  
Skills Training ◽  
Future Research ◽  
Treatment Approaches

IntroductionIt has been hypothesized that cognitive remediation with adjunctive psychiatric rehabilitation would be associated with greater improvements in functional outcome than standalone treatment approaches (1).Moving from these observations our group designed an individualized rehabilitation program including a computerized cognitive training (CCT) and social skills training (SST), which showed promising results (2).A critical evaluation of recent studies examining standalone and combined treatment approaches included the understanding of the differential impact of the two approaches among crucial areas for future research (3).ObjectivesThe present study compared the effects of CCT and SST on several indices of outcome in psychotic patients. Fifty-eight patients with schizophrenia or schizoaffective disorder were randomly assigned to one of two treatment groups: CCT or SST. Changes in cognitive, psychopathological and psychosocial indices after 6 and 12 months were compared between the two groups.ResultsAfter both 6 and 12 months, an improvement of psychosocial indices was observed in both groups, while cognitive functions improved only after CCT; the improvement of psychopathological indices, observed in both groups, was greater in the CCT group.ConclusionsOur findings suggest that CCT is associated with a greater impact than SST on different indices of outcome in psychotic patients. Future research should focus on possible synergistic effects of cognitive remediation and social skills training on functional outcome.

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