The Feasibility and Effectiveness of Home-based Cognitive Remediation in Clinically Stable Schizophrenia Patients Attending a North Indian Tertiary Care Institution

Home-based cognitive remediation in clinically stable schizophrenia patients

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Published

2022-05-08

DOI:

https://doi.org/10.55229/ijbs2022.0306

Keywords:

Cognitive remediation, Home-based cognitive training, Schizophrenia, Disability, Quality of life

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Vol. 25 No. 01 (2022): Indian Journal of behavioural Sciences

Section

ORIGINAL RESEARCH ARTICLES

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Copyright (c) 2022 Vikas Moun, Adarsh Tripathi, Pronob Dalal, Sujita Kar, Pawan Gupta, Shweta Singh, Dr. Mohita Joshi

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Authors

  • Vikas Moun EX-SENIOR RESIDENT, DEPARTMENT OF PSYCHIATRY, POST GRADUATE INSTITUTE OF MEDICAL SCIENCES, ROHTAK, HARYANA, INDIA
  • Adarsh Tripathi ADDITIONAL PROFESSOR, DEPARTMENT OF PSYCHIATRY, KING GEORGE’S MEDICAL UNIVERSITY, LUCKNOW, U.P, INDIA
  • Pronob Dalal EX-PROFESSOR, DEPARTMENT OF PSYCHIATRY, KING GEORGE’S MEDICAL UNIVERSITY, LUCKNOW, U.P, INDIA
  • Sujita Kar ADDITIONAL PROFESSOR, DEPARTMENT OF PSYCHIATRY, KING GEORGE’S MEDICAL UNIVERSITY, LUCKNOW, U.P, INDIA
  • Pawan Gupta ADDITIONAL PROFESSOR, DEPARTMENT OF PSYCHIATRY, KING GEORGE’S MEDICAL UNIVERSITY, LUCKNOW, U.P, INDIA
  • Shweta Singh ADDITIONAL PROFESSOR IN CLINICAL PSYCHOLOGY, DEPARTMENT OF PSYCHIATRY, KING GEORGE’S MEDICAL UNIVERSITY, LUCKNOW, U.P, INDIA
  • Dr. Mohita Joshi a:1:{s:5:"en_US";s:40:"King George's Medical University Lucknow";}

Abstract

Background: Cognitive deficits are one of the core symptoms of Schizophrenia that compromises real-world functioning, adversely impacts rehabilitation, and negatively influence the quality of life. Studies evaluating interventions for cognitive remediation in Schizophrenia are scarce in India.  This study aimed to evaluate the effectiveness of the add-on home-based cognitive remediation strategy in schizophrenia in comparison to the schizophrenic patients receiving treatment as usual. 

Methods: The research was carried out in a North Indian tertiary care teaching hospital. Clinically stable patients diagnosed with schizophrenia were randomly assigned to study and control groups. The control group had received treatment as usual, whereas the study group had received 8 weeks of home-based manual-based cognitive remediation in addition to the treatment as usual. Assessment of psychopathology, cognitive functioning, disability, and quality of life was done at baseline, completion at 8 weeks and 16 weeks follow up.

Results: A total of 186 patients with schizophrenia were screened based on selection criteria. 74 patients were included in the study. During the intervention, 17 patients were dropped out, making the sample size of the study group to be 28 and the control group to be 29. At the baseline, the socio-demographic, as well as clinical variables, were comparable. After cognitive remediation intervention, the study group had better cognitive functioning, less disability, and better quality of life in comparison to the control group. The benefits were sustained in the study group at the end of two-month follow-up period. The effect size of home-based cognitive remediation was found to be moderate (Cohen’s d 0.4 to 0.69) at the end of the intervention.

Conclusion: Home-based cognitive remediation is a feasible and effective strategy of intervention in patients with schizophrenia which has at least a short-lasting effect and it is also useful in limiting the disability and improving the quality of life.

How to Cite

Moun, V., Tripathi, A., Dalal, P., KAR, S. K., Gupta, P. K. ., Singh, S., & Joshi, D. M. (2022). The Feasibility and Effectiveness of Home-based Cognitive Remediation in Clinically Stable Schizophrenia Patients Attending a North Indian Tertiary Care Institution: Home-based cognitive remediation in clinically stable schizophrenia patients . Indian Journal of Behavioural Sciences, 25(01), 25–34. https://doi.org/10.55229/ijbs2022.0306

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Author Biographies

Vikas Moun, EX-SENIOR RESIDENT, DEPARTMENT OF PSYCHIATRY, POST GRADUATE INSTITUTE OF MEDICAL SCIENCES, ROHTAK, HARYANA, INDIA

EX-SENIOR RESIDENT, DEPARTMENT OF PSYCHIATRY, POST GRADUATE INSTITUTE OF MEDICAL SCIENCES, ROHTAK, HARYANA, INDIA

Adarsh Tripathi, ADDITIONAL PROFESSOR, DEPARTMENT OF PSYCHIATRY, KING GEORGE’S MEDICAL UNIVERSITY, LUCKNOW, U.P, INDIA

ADDITIONAL PROFESSOR, DEPARTMENT OF PSYCHIATRY, KING GEORGE’S MEDICAL UNIVERSITY, LUCKNOW, U.P, INDIA

Pronob Dalal, EX-PROFESSOR, DEPARTMENT OF PSYCHIATRY, KING GEORGE’S MEDICAL UNIVERSITY, LUCKNOW, U.P, INDIA

EX-PROFESSOR, DEPARTMENT OF PSYCHIATRY, KING GEORGE’S MEDICAL UNIVERSITY, LUCKNOW, U.P, INDIA

Sujita Kar, ADDITIONAL PROFESSOR, DEPARTMENT OF PSYCHIATRY, KING GEORGE’S MEDICAL UNIVERSITY, LUCKNOW, U.P, INDIA

ADDITIONAL PROFESSOR, DEPARTMENT OF PSYCHIATRY, KING GEORGE’S MEDICAL UNIVERSITY, LUCKNOW, U.P, INDIA

Pawan Gupta, ADDITIONAL PROFESSOR, DEPARTMENT OF PSYCHIATRY, KING GEORGE’S MEDICAL UNIVERSITY, LUCKNOW, U.P, INDIA

ADDITIONAL PROFESSOR, DEPARTMENT OF PSYCHIATRY, KING GEORGE’S MEDICAL UNIVERSITY, LUCKNOW, U.P, INDIA

Shweta Singh, ADDITIONAL PROFESSOR IN CLINICAL PSYCHOLOGY, DEPARTMENT OF PSYCHIATRY, KING GEORGE’S MEDICAL UNIVERSITY, LUCKNOW, U.P, INDIA

ADDITIONAL PROFESSOR IN CLINICAL PSYCHOLOGY, DEPARTMENT OF PSYCHIATRY, KING GEORGE’S MEDICAL UNIVERSITY, LUCKNOW, U.P, INDIA

References

Owen MJ, Sawa A, Mortensen PB. Schizophrenia. The Lancet. 2016 Jul 2;388(10039):86–97.

Bora E. Peripheral inflammatory and neurotrophic biomarkers of cognitive impairment in schizophrenia: a meta-analysis. Psychol Med. 2019 Sep;49(12):1971–9.

Barch DM. Neuropsychological abnormalities in schizophrenia and major mood disorders: Similarities and differences. Curr Psychiatry Rep. 2009 Jul 21;11(4):313.

Helldin L, Mohn C, Olsson A-K, Hjärthag F. Neurocognitive variability in schizophrenia spectrum disorders: relationship to real-world functioning. Schizophr Res Cogn. 2020 Feb 14;20:100172.

Sheffield JM, Karcher NR, Barch DM. Cognitive Deficits in Psychotic Disorders: A Lifespan Perspective. Neuropsychol Rev. 2018 Dec 1;28(4):509–33.

Fatouros-Bergman H, Cervenka S, Flyckt L, Edman G, Farde L. Meta-analysis of cognitive performance in drug-naïve patients with schizophrenia. Schizophr Res. 2014 Sep;158(1–3):156–62.

Fioravanti M, Bianchi V, Cinti ME. Cognitive deficits in schizophrenia: an updated metanalysis of the scientific evidence. BMC Psychiatry. 2012 Jun 20;12:64.

Harvey PD. The Course of Cognition and Functioning in Patients at Ultrahigh Risk of Developing Psychosis: The Roles of Remission and Persistent Nonconverting Symptoms. JAMA Psychiatry. 2018 Sep 1;75(9):882–3.

Strassnig M, Signorile J, Gonzalez C, Harvey PD. Physical performance and disability in schizophrenia. Schizophr Res Cogn. 2014 Jun 1;1(2):112–21.

Fett A-KJ, Viechtbauer W, Dominguez M-G, Penn DL, van Os J, Krabbendam L. The relationship between neurocognition and social cognition with functional outcomes in schizophrenia: a meta-analysis. Neurosci Biobehav Rev. 2011 Jan;35(3):573–88.

Galderisi S, Rossi A, Rocca P, Bertolino A, Mucci A, Bucci P, et al. The influence of illness-related variables, personal resources and context-related factors on real-life functioning of people with schizophrenia. World Psychiatry Off J World Psychiatr Assoc WPA. 2014 Oct;13(3):275–87.

Galderisi S, Mucci A, Maj M. Untangling the Factors Contributing to Functional Outcome in Schizophrenia-Reply. JAMA Psychiatry. 2018 Jul 1;75(7):754–5.

Hegde S, Thirthalli J, Rao SL, Raguram A, Philip M, Gangadhar BN. Cognitive deficits and its relation with psychopathology and global functioning in first episode schizophrenia. Asian J Psychiatry. 2013 Dec 1;6(6):537–43.

Alkan E, Davies G, Evans SL. Cognitive impairment in schizophrenia: relationships with cortical thickness in fronto-temporal regions, and dissociability from symptom severity. Npj Schizophr. 2021 Mar 18;7(1):1–9.

Peng X-J, Hei G-R, Yang Y, Liu C-C, Xiao J-M, Long Y-J, et al. The Association Between Cognitive Deficits and Clinical Characteristic in First-Episode Drug Naïve Patients With Schizophrenia. Front Psychiatry. 2021;12:638773.

Keefe RSE, Bilder RM, Davis SM, Harvey PD, Palmer BW, Gold JM, et al. Neurocognitive Effects of Antipsychotic Medications in Patients With Chronic Schizophrenia in the CATIE Trial. Arch Gen Psychiatry. 2007 Jun 1;64(6):633–47.

Keel JC, Smith MJ, Wassermann EM. A safety screening questionnaire for transcranial magnetic stimulation. Clin Neurophysiol Off J Int Fed Clin Neurophysiol. 2001 Apr;112(4):720.

Rehse M, Bartolovic M, Baum K, Richter D, Weisbrod M, Roesch-Ely D. Influence of Antipsychotic and Anticholinergic Loads on Cognitive Functions in Patients with Schizophrenia. Schizophr Res Treat. 2016 Apr 10;2016:e8213165.

Rund BR, Borg NE. Cognitive deficits and cognitive training in schizophrenic patients: a review. Acta Psychiatr Scand. 1999 Aug;100(2):85–95.

Patel A, Knapp M, Romeo R, Reeder C, Matthiasson P, Everitt B, et al. Cognitive remediation therapy in schizophrenia: cost-effectiveness analysis. Schizophr Res. 2010 Jul;120(1–3):217–24.

Hegde S, Rao SL, Raguram A, Gangadhar BN. Addition of home-based cognitive retraining to treatment as usual in first episode schizophrenia patients: A randomized controlled study. Indian J Psychiatry. 2012;54(1):15–22.

Üstün TB, Chatterji S, Kostanjsek N, Rehm J, Kennedy C, Epping-Jordan J, et al. Developing the World Health Organization disability assessment schedule 2.0. Bull World Health Organ. 2010;88:815–23.

Keefe RSE, Poe M, Walker TM, Harvey PD. The relationship of the Brief Assessment of Cognition in Schizophrenia (BACS) to functional capacity and real-world functional outcome. J Clin Exp Neuropsychol. 2006 Feb;28(2):260–9.

WHOQoL Group. Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med. 1998;28(3):551–8.

Bon L, Franck N. The impact of cognitive remediation on cerebral activity in schizophrenia: Systematic review of the literature. Brain Behav. 2018 Feb 7;8(3):e00908.

Penadés R, González-Rodríguez A, Catalán R, Segura B, Bernardo M, Junqué C. Neuroimaging studies of cognitive remediation in schizophrenia: A systematic and critical review. World J Psychiatry. 2017 Mar 22;7(1):34–43.

Ramsay IS, MacDonald AW. Brain Correlates of Cognitive Remediation in Schizophrenia: Activation Likelihood Analysis Shows Preliminary Evidence of Neural Target Engagement. Schizophr Bull. 2015 Nov;41(6):1276–84.

Jahshan C, Vinogradov S, Wynn JK, Hellemann G, Green MF. A randomized controlled trial comparing a “bottom-up” and “top-down” approach to cognitive training in schizophrenia. J Psychiatr Res. 2019;109:118–25.

Bralet MC, Navarre M, Eskenazi AM, Lucas-Ross M, Falissard B. [Interest of a new instrument to assess cognition in schizophrenia: The Brief Assessment of Cognition in Schizophrenia (BACS)]. L’Encephale. 2008 Dec;34(6):557–62.

Keefe RSE, Harvey PD, Goldberg TE, Gold JM, Walker TM, Kennel C, et al. Norms and standardization of the Brief Assessment of Cognition in Schizophrenia (BACS). Schizophr Res. 2008 Jul;102(1–3):108–15.

Kumar P, Sen RK, Aggarwal S, Jindal K, Rajnish RK. Assessment and reliability of the World Health Organisation quality of life (WHO QOL-BREF) questionnaire in total hip replacement patients. J Clin Orthop Trauma. 2020 Oct;11(Suppl 5):S756–9.

Shiraishi N, Reilly J. Positive and negative impacts of schizophrenia on family caregivers: a systematic review and qualitative meta-summary. Soc Psychiatry Psychiatr Epidemiol. 2019 Mar;54(3):277–90.

Wykes T, Huddy V, Cellard C, McGurk SR, Czobor P. A meta-analysis of cognitive remediation for schizophrenia: methodology and effect sizes. Am J Psychiatry. 2011 May;168(5):472–85.

Medalia A, Choi J. Cognitive remediation in schizophrenia. Neuropsychol Rev. 2009 Sep;19(3):353–64.

Kurtz MM, Moberg PJ, Gur RC, Gur RE. Approaches to cognitive remediation of neuropsychological deficits in schizophrenia: a review and meta-analysis. Neuropsychol Rev. 2001 Dec;11(4):197–210.

Penadés R, Catalán R, Salamero M, Boget T, Puig O, Guarch J, et al. Cognitive remediation therapy for outpatients with chronic schizophrenia: a controlled and randomized study. Schizophr Res. 2006 Oct;87(1–3):323–31.

Wykes T, Reeder C, Landau S, Everitt B, Knapp M, Patel A, et al. Cognitive remediation therapy in schizophrenia: randomised controlled trial. Br J Psychiatry J Ment Sci. 2007 May;190:421–7.

Ojeda N, Sánchez P, Peña J, Elizagárate E, Yoller AB, Gutiérrez-Fraile M, et al. An explanatory model of quality of life in schizophrenia: the role of processing speed and negative symptoms. Actas Esp Psiquiatr. 2012 Feb;40(1):10–8.

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