EPA-1775 – Cognitive Remediation in First Psychosis Episodes. Does it Improve Functioning?

Abstract

Cognitive deficits are known to be present in psychotic patients even before psychosis has been diagnosed. Those deficits show poor response to antipsychotics and seem to be responssible of functional impairment.

Several trials point out cognitive remediation interventions may improve these neuropsychological deficits and therefore functioning.

Our aim is to evaluate if a computerized cognitive remediation program (Rehacom®) improves cognition, and therefore insight, functioning and quality of life in early stages of psychosis.

A randomized open label prospective study comparing 21 first psychotic outpatients doing RehaCom with 21 first psychotic patients doing non specific computer work. All 42 patients have done 24 one hour sessions, twice a week during 12 consecutive weeks. The trial was conducted between january 1st and december 31st, 2013. All patients were evaluated using the Matrics Cognitive Consensus Battery (MCCB), the Scale Unawarness of Mental Disorders (SUMD), the Global Assessment of Functioning (GAF) and the Quality of Life Scale (QLS) at basal time, 6 and 12 months later.

Basal differences between groups were analized using Chi2 and U-Man Whitney. STATA v.11 was used for the analysis.

MCCB total score were 32, 34 and 38 at basal time, midtime and endpoint. All patients show neuropsicological improvement after a year but no statistical differences were found between groups. Education was associated with better scores after cognitive remediation, The RehaCom group did show better scores in insight (p<0.041) but not in functioning or quality of life.