Cognitive Remediation for First Episode of Psychosis Patients

University of Manchester

Status: Completed

Conditions: Psychosis

Treatments: Behavioral: Social cognition training; Behavioral: Cognitive remediation

Study type: Interventional

Funder types: Other

Identifiers

NCT01967420

13/NW/0385

Details and patient eligibility

About

This study aims to look at the effectiveness of a combination of cognitive remediation and social cognition training to improve cognition and functioning when compared to cognitive remediation alone. The target population will be those who are experiencing their first episode of psychosis.

Full description

A first episode of psychosis is defined as the first experience of positive symptoms, such as hallucinations and delusions, and the behaviour that accompanies it. This is associated with problems in many areas of cognition; the ability to acquire knowledge and understanding. These cognitive symptoms have been found to have a large impact on daily functioning (e.g. accessing education or employment and maintaining relationships) and cannot effectively be treated with medication. Cognitive remediation (CR) is a therapy that aims to improve cognition and, through generalisation of this, improve daily functioning and quality of life. Although it is an area of deficit, social cognition, the ability to perceive and understand emotional states, is often not targeted in cognitive remediation. However, interventions which have focused on providing social cognition training (SCT) alongside CR have shown large improvements in daily functioning.

This study aims to look at the effectiveness of a combination of CR and SCT to improve cognition and functioning when compared to CR alone. The target population will be those who are experiencing their first episode of psychosis. Participants will be recruited from an Early Intervention in Psychosis service which is an NHS service set up to provide rapid treatment for those experiencing psychosis.

Participants will take part in a ten week CR or CR+SCT intervention which will consist of spending 90 minutes a week in a small group setting working through a series of computer games which aim to improve cognition. Interviews and questionnaires regarding daily functioning, cognition, quality of life and symptoms will be used before and after the intervention. Participants will be asked to attend follow-up interviews 6 months after the intervention has ended to complete the measures again to see if any beneficial effects have lasted.

Enrollment: 40 patients

Sex: All

Ages: 18 to 35 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Non-affective psychosis
• Premorbid IQ of over 70
• A service user of the early intervention service
• Aged 18 or over (up to the age of 35 which is the limit for the early intervention service)
• Psychiatrically stable enough to attend to completion (no hospitalisations or medication changes in last 4 weeks)

Exclusion criteria

• Active substance dependency
• History of severe head injury

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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40 participants in 2 patient groups

Cognitive remediation plus social cognition training

Experimental group

Description:

A combined intervention of 60 minutes of computerised cognitive remediation and 30 minutes of computerised social cognition training.

Treatment:

Behavioral: Cognitive remediation

Behavioral: Social cognition training

Cognitive remediation alone

Active Comparator group

Description:

An active control condition consisting of 60 minutes of computerised cognitive remediation and 30 minutes of free computer time.

Treatment:

Behavioral: Cognitive remediation