Cognitive remediation to address impairment in schizophrenia: Moving beyond effectiveness and toward implementation

doi:10.1016/j.psychres.2021.114232

Psychiatry Research

Volume 305, November 2021, 114232

https://doi.org/10.1016/j.psychres.2021.114232 Get rights and content

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Declaration of Competing Interest

KA is supported by a Career Development Fellowship from the National Health and Medical Research Council (NHMRC; APP1141207). NHMRC did not have any role in, or influence on, the present paper.

References (5)

K. Allott et al.
Compensatory interventions for cognitive impairments in psychosis: a systematic review and meta-analysis
Schizophr. Bull.
(2020)
G.M. Curran et al.
Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact
Med. Care
(2012)

There are more references available in the full text version of this article.

Cited by (5)

Cognition is a treatment priority for young people with psychosis: Findings from the Your Mind, Your Choice survey
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Digital technology for addressing cognitive impairment in recent-onset psychosis: A perspective
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Citation Excerpt :
The development of Apps by comparison is cheaper. In general there is a need for cost-effectiveness to be added to trials to estimate if implementation of digital solutions is economically viable for treating cognitive impairment (Bryce et al., 2021). The authors believe further developments should include smartphone and VR-based interventions, particularly supporting human-supported CR and functional recovery in real-world environments.
Cognitive impairments in psychosis negatively impact functional recovery and quality of life. Existing interventions for improving cognitive impairment in recent-onset psychosis show inconsistent treatment efficacy, small effects, suboptimal engagement and limited generalizability to daily life functioning. In this perspective we explore how digital technology has the potential to address these limitations in order to improve cognitive and functional outcomes in recent-onset psychosis. Computer programs can be used for standardized, automated delivery of cognitive remediation training. Virtual reality provides the opportunity for learning and practicing cognitive skills in real-world scenarios within a virtual environment. Smartphone apps could be used for notification reminders for everyday tasks to compensate for cognitive difficulties. Internet-based technologies can offer psychoeducation and training materials for enhancing cognitive skills. Early findings indicate some forms of digital interventions for cognitive enhancement can be effective, with well-established evidence for human-supported computer-based cognitive remediation in recent-onset psychosis. Emerging evidence regarding virtual reality is favorable for improving social cognition. Overall, blending digital interventions with human support improves engagement and effectiveness. Despite the potential of digital interventions for enhancing cognition in recent-onset psychosis, few studies have been conducted to date. Implementation challenges affecting application of digital technologies for cognitive impairment in recent-onset psychosis are sustained engagement, clinical integration, and lack of quality in the commercial marketplace. Future opportunities lie in including motivational frameworks and behavioral change interventions, increasing service engagement in young people and lived experience involvement in digital intervention development.
European Psychiatric Association guidance on treatment of cognitive impairment in schizophrenia
2022, European Psychiatry
Cognitive health treatment priorities and preferences among young people with mental illness: The your mind, your choice survey
2024, Early Intervention in Psychiatry
The use of implementation science to close the research-to-treatment gap for cognitive impairment in psychosis
2023, Australian and New Zealand Journal of Psychiatry

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Letter to the EditorCognitive remediation to address impairment in schizophrenia: Moving beyond effectiveness and toward implementation

Section snippets

Declaration of Competing Interest

Compensatory interventions for cognitive impairments in psychosis: a systematic review and meta-analysis

Schizophr. Bull.

Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact

Med. Care

Letter to the Editor
Cognitive remediation to address impairment in schizophrenia: Moving beyond effectiveness and toward implementation