Effectiveness, Core Elements, and Moderators of Response of Cognitive Remediation for Schizophrenia

作者：Antonio Vita, Sergio Barlati, Anna Ceraso, Gabriele Nibbio, Cassandra Ariu, Giacomo Deste, Til Wykes · 发表于：JAMA Psychiatry · 年份：2021 · DOI：10.1001/jamapsychiatry.2021.0620 · 被引用次数：471 · 研究领域：Schizophrenia research and treatment、Memory and Neural Mechanisms、Mental Health and Psychiatry

Importance: Cognitive impairment is a core feature of schizophrenia, with negative consequences on functional outcomes. Although cognitive remediation (CR) is effective and mentioned in treatment guidance for schizophrenia, its active ingredients and ideal candidates are still debated. Objective: To provide a comprehensive update on CR effectiveness for cognition and functioning in schizophrenia and analyze the core ingredients of efficacy and role of patient characteristics. Data Sources: The reference list of the last comprehensive meta-analysis in 2011 was screened against eligibility criteria. Then, electronic databases (PubMed, Scopus, and PsycInfo) were systematically searched for articles published from January 2011 to February 2020. Reference lists of included articles and relevant reviews were hand searched, and Google Scholar was manually inspected. Study Selection: Eligible studies were randomized clinical trials comparing CR with any other control condition in patients diagnosed with schizophrenia spectrum disorders (with an unrestricted clinical status). Screening was performed by at least 2 independent reviewers. Data Extraction and Synthesis: The PRISMA guidelines were followed. Study data were independently extracted and pooled using random-effect models. Cohen d was used to measure outcomes. Trial methodological quality was evaluated with the Clinical Trials Assessment Measure. Main Outcomes and Measures: Primary outcomes were changes in global cognition and ...