Schizophrenia Clinical Trial
Official title:
Efficacy of a Cognitive Remediation Treatment in Adolescents With Schizophrenia Spectrum Disorders
Cognitive Remediation Therapy (CRT) can enhance cognitive performance in schizophrenia improving functional outcome. But most of the studies have involved participants who are in average in their mid 30s, and little is known about the efficacy of CRT in adolescents with early-onset schizophrenia (EOS). The aim of this study is to investigate efficacy of CRT in improving cognitive performance and functional outcome in adolescents with EOS. We expect to find that CRT improves cognitive and functional outcomes in adolescents with schizophrenia.
Early-onset schizophrenia (EOS) is associated with worse course and poor outcome than
adulthood schizophrenia. Cognitive deficits are known to be a core feature in EOS, with large
deficits on almost all cognitive domains. Importantly, cognitive deficits are known to be
strong predictors of psychosocial and functional outcomes in schizophrenia and also in the
early-onset form of the illness. Cognitive Remediation Therapy (CRT) is a behavioral training
based intervention that aims to improve cognitive processes (attention, memory, executive
function, social cognition or metacognition) with the goal of durability and generalization.
It has been demonstrated that CRT improve cognitive deficits and functional outcome in adult
patients but there are very few studies with adolescent samples.
A controlled randomized study will be carry out with two groups: patients receiving treatment
as usual plus CRT, and patients receiving treatment as usual (TAU). The independent variable
is the cognitive remediation treatment. The CRT will be applied according to the manual of
Wykes and Reeder (2005). The program has a duration of 40 sessions, with two session for
week. It is carried out individually and utilizes paper and pencil tasks. The main technique
utilized is the scaffolding in a context of learning without errors.
The main dependent variable is the cognitive performance measured through neuropsychological
tests. Other secondary dependent variables are functional outcome and clinical symptoms
obtained from the psychometric evaluation.
All participants will be evaluated before and after the experimental intervention in several
neurocognitive domains, clinical symptoms and functional outcome. The evaluations will be
carried out by expert evaluators. Intention-to-treat analysis will be carry out using the
statistical package SPSS v 18.
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