Integrated cognitive remediation and standard rehabilitation therapy in patients of schizophrenia: persistence after 5 years

Cognitive remediation, often used in combination with standard rehabilitation programs, represents the best available tool to treat cognitive impairments in patients with schizophrenia. However, there are still open questions about durability of effects and generalization of cognitive improvements to functional outcome. This study aims to investigate the persistence of both cognitive and functional effects of combined cognitive remediation plus standard rehabilitation interventions, 5 years after completion of the intervention, also comparing different durations of the standard rehabilitation. Sixty patients diagnosed with schizophrenia and previously treated with a 6 months intervention, consisting of standard rehabilitation plus 3-months of cognitive remediation, either followed by another year of standard rehabilitation or routine psychiatric treatment, were reassessed with neuropsychological and functional measures 5 years after the intervention. Results show that cognitive abilities remained stable after 5 years in both groups, while functional performance significantly decreased in patients treated with the 6 months intervention only. Data thus suggest that cognitive effects persist even after 5 years, while a longer standard rehabilitation following the cognitive remediation program may be needed to achieve a stable functional gain. (C) 2017 Elsevier B.V. All rights reserved.