Full Text Full Text (PDF) Supplemental material Alert me when this article is cited Alert me if a correction is posted Citation Map Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Articles by Eack, S. M. Articles by Keshavan, M. S. PubMed Citation Articles by Eack, S. M. Articles by Keshavan, M. S. Schizophrenia Spectrum Disorders Behavior Therapy Cognitive Therapy Related Article

Cognitive Enhancement Therapy for Early-Course Schizophrenia: Effects of a Two-Year Randomized Controlled Trial

Dr. Eack is affiliated with the School of Social Work and Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh. The other authors are with the Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh. Address correspondence to Dr. Keshavan, who is also affiliated with Beth Israel Deaconess Medical Center and Harvard Medical School, 401 Park Dr., Boston MA 02215 (e-mail: mkeshava{at}bidmc.harvard.edu). Professor Gerard E. Hogarty codirected and contributed to this study, but his death in April 2006 prevented his approving the final manuscript to meet criteria for authorship.

OBJECTIVE: The early application of cognitive rehabilitation may afford long-term functional benefits to patients with schizophrenia. This study examined the two-year effects of an integrated neurocognitive and social-cognitive rehabilitation program, cognitive enhancement therapy (CET), on cognitive and functional outcomes in early-course schizophrenia. METHODS: Early-course outpatients (mean±SD illness duration=3.19±2.24 years) with schizophrenia or schizoaffective disorder were randomly assigned to CET (N=31) or enriched supportive therapy (EST) (N=27), an illness management intervention utilizing psychoeducation and applied coping strategies, and treated for two years. Multivariate composite indexes of cognitive, social adjustment, and symptom domains were derived from assessment batteries administered annually by computer-based tests and raters not blind to treatment assignment. RESULTS: Of the 58 participants who were randomly assigned and treated, 49 and 46 completed one year and two years of treatment, respectively. Intent-to-treat analyses showed significant differential effects favoring CET on social cognition, cognitive style, social adjustment, and symptomatology composites during the first year of treatment. After two years, moderate effects (d=.46) were observed favoring CET for enhancing neurocognitive function. Strong differential effects (d>1.00) on social cognition, cognitive style, and social adjustment composites remained at year 2 and also extended to measures of symptomatology, particularly negative symptoms. CONCLUSIONS: CET appears to be an effective approach to the remediation of cognitive deficits in early schizophrenia that may help reduce disability in this population. The remediation of such deficits should be an integral component of early intervention programs treating psychiatrically stable schizophrenia outpatients.

Related Article:

November: This Month's Highlights
Psychiatr Serv 2009 60: 1425. [Full Text] [PDF]

Get information about faster international access.

Privacy Policy

Copyright © 2009 American Psychiatric Association. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us