Schizophrenia Clinical Trial
Official title:
Improving Basic and Social Cognition in Veterans With Schizophrenia
Veterans with schizophrenia and schizoaffective disorder experience very high levels of disability and poor community outcome. Further improvements in community outcome for patients with these disorders will not occur simply through better control of clinical symptoms. Instead, it will be necessary to find treatments that address the key determinants of poor functional outcome. Evidence strongly suggests that basic (non-social) cognitive and social cognitive deficits are among the key determinants of functional outcome for these illnesses. The primary goal of this 2-year pilot study is to implement and validate a new remediation program for social cognition that is appropriate for veterans with schizophrenia and schizoaffective disorder.
Veterans with schizophrenia and schizoaffective disorder experience very high levels of
disability and poor community outcome. Further improvements in community outcome for
patients with these disorders will not occur simply through better control of clinical
symptoms. Instead, it will be necessary to find treatments that address the key determinants
of poor functional outcome. Evidence strongly suggests that basic (non-social) cognitive and
social cognitive deficits are among the key determinants of functional outcome for these
illnesses. The primary goal of this 2-year pilot study is to implement and validate a new
remediation program for social cognition that is appropriate for veterans with schizophrenia
and schizoaffective disorder.
We plan to recruit 72 patients over the 2 years of the study from the outpatient clinics at
the VA Greater Los Angeles Healthcare System (VAGLAHS). They will receive baseline
assessment that includes measures of social cognition, basic cognition, electrophysiology,
functional capacity, clinical symptoms, community status, and demographics / clinical
history. Follow up assessments will be administered at the mid-point of training (at 6
weeks) and end of training (at 12 weeks). Each follow up assessment will include measures of
basic cognition, social cognition, electrophysiology, functional capacity, and clinical
symptoms. The tester administering the assessments will be blind to treatment group.
Subjects will be randomly assigned to one of four groups: 1) social cognitive training, 2)
basic cognitive remediation, 3) a combined social cognitive and basic cognitive
intervention, or 4) social skills training. All groups will meet in one-hour sessions held
twice a week over the course of 12 weeks in small groups of 3-6. The Social Cognition
Intervention (SCI) is a new 24-session, manualized intervention program specifically
designed to improve emotion perception, social context processing, and theory of mind /
attributional bias in veterans with schizophrenia and schizoaffective disorder. The Basic
Cognitive Intervention (BCI) will involve computer-assisted training exercises. Each
participant will work individually on a notebook computer. The combined intervention will
cover the same content areas as the social cognitive and basic cognitive interventions, but
will not go into as much detail as the separate intervention programs. The control condition
will be facilitated discussion of current events. Treatment will be administered in a group
format with three to six patients and a training coach.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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