Does the Role of Family Assisted Cognitive Remediation Therapy Still Exists in Modern Era of Artificial Intelligence: A Randomized Case-control Study for Schizophrenia Patients from Rural Background

Abstract

Background: Last decade showed promising evidences of computer based therapies, incorporating either an in-patient or home-based computer model for training the family members. The crux of all these studies focuses on the role of “family”. The compliance and perception, from a patient perspective, especially in a developing country, is still unproven.

Purpose and Design: The aim of our randomized case-control study, was to analyze the impact of add-on FACT in stable patients of Schizophrenia and assess and the level of functioning and quality of life (QoL) among two groups.  The primary outcome measures (PANSS and SCoRS) and secondary outcome measure (GAF and WHODAS) were compared among two groups.

Material and methods: 96 patients of stable Schizophrenia, were randomized in two groups, Group A (study group, n=48) included patients, who receive add-on FACT and Group B (control group, n=48) includes the patients on our standard protocol (pharmacotherapy and brief counselling). Both the groups received single session of psycho-education with, Group A receiving an additional four training sessions. We targeted prospective memory, conversational and task vigilance, verbal learning and memory, cognitive flexibility and problem solving in our sessions. Assessments were done at baseline, 8 and 16 weeks and domains were compared.

Results: There was significant improvement in outcome measures of psychopathology, level of functioning, quality of life and disability among patients of Group A. Of the cognitive domains, trend of an improvements was seen inattention/vigilance, working memory, processing speed, household responsibility and social cognition.

Conclusion: The collaborative efforts of treating physician and family involvement showed significant clinical outcome. FACT holds promise in the rehabilitation for stable patients of schizophrenia. The therapy modifies family dynamics, retaining the roots of psycho-education and tailored cognitive therapy model; irreplaceable for any artificial intelligence model.