PMID- 29525739
OWN - NLM
STAT- MEDLINE
DCOM- 20190902
LR  - 20191210
IS  - 1879-1379 (Electronic)
IS  - 0022-3956 (Linking)
VI  - 101
DP  - 2018 Jun
TI  - Mechanisms of functional improvement through cognitive rehabilitation in 
      schizophrenia.
PG  - 21-27
LID - S0022-3956(17)31304-3 [pii]
LID - 10.1016/j.jpsychires.2018.03.002 [doi]
AB  - Whereas the efficacy of cognitive rehabilitation in schizophrenia is widely 
      known, studies examining mechanisms for functional improvement are still scarce. 
      The aim of the study was to examine the mediational mechanisms through which 
      cognitive rehabilitation improves functioning in schizophrenia. One hundred and 
      eleven schizophrenia patients were randomly assigned to either a 4-month 
      cognitive rehabilitation group or an active control group. Patients underwent a 
      neurocognitive battery (including processing speed, verbal memory, working memory 
      and executive functioning) and social cognition assessment (emotion perception, 
      theory of mind and social perception). Functioning was assessed by the combined 
      use of a performance-based instrument, the UCSD Performance-based Skills 
      Assessment (UPSA) and an observer-rated instrument, the Global Assessment of 
      Functioning (GAF). The trial was registered in clinicaltrials.gov (NCT02796417). 
      Multiple mediational analyses revealed that the effect of cognitive 
      rehabilitation on functional improvement was partially mediated by changes in 
      processing speed and verbal memory, but not by the domains of social cognition 
      and negative symptoms. More specifically, verbal memory partially mediated the 
      treatment's effect on performance-based functioning (UPSA), whereas processing 
      speed acted as a partial mediator for observer-rated functioning (GAF). The 
      effect of rehabilitation on functioning did not take place through all the 
      domains that showed significant improvement. Verbal memory and processing speed 
      emerged as the most crucial factors. However, these complex interactions need 
      further research.
CI  - Copyright (c) 2018. Published by Elsevier Ltd.
FAU - Pena, J
AU  - Pena J
AD  - Department of Methods and Experimental Psychology, Faculty of Psychology and 
      Education, University of Deusto, Bilbao, Basque Country, Spain. Electronic 
      address: javier.pena@deusto.es.
FAU - Ibarretxe-Bilbao, N
AU  - Ibarretxe-Bilbao N
AD  - Department of Methods and Experimental Psychology, Faculty of Psychology and 
      Education, University of Deusto, Bilbao, Basque Country, Spain.
FAU - Sanchez, P
AU  - Sanchez P
AD  - Refractory Psychosis Unit, Hospital Psiquiatrico de Alava, Red de Salud Mental de 
      Araba, Osakidetza, Vitoria, Spain; Department of Neuroscience, School of 
      Medicine, University of the Basque Country, Vizcaya, Spain.
FAU - Uriarte, J J
AU  - Uriarte JJ
AD  - Red de Salud Mental de Bizkaia Osakidetza, Bilbao, Spain.
FAU - Elizagarate, E
AU  - Elizagarate E
AD  - Refractory Psychosis Unit, Hospital Psiquiatrico de Alava, Red de Salud Mental de 
      Araba, Osakidetza, Vitoria, Spain; Department of Neuroscience, School of 
      Medicine, University of the Basque Country, Vizcaya, Spain; CIBERSAM, Centro de 
      Investigacion Biomedica en Red de Salud Mental Madrid, Spain.
FAU - Gutierrez, M
AU  - Gutierrez M
AD  - Department of Neuroscience, School of Medicine, University of the Basque Country, 
      Vizcaya, Spain; CIBERSAM, Centro de Investigacion Biomedica en Red de Salud 
      Mental Madrid, Spain; Department of Psychiatry, Hospital Universitario Alava-Sede 
      Santiago, Vitoria, Spain.
FAU - Ojeda, N
AU  - Ojeda N
AD  - Department of Methods and Experimental Psychology, Faculty of Psychology and 
      Education, University of Deusto, Bilbao, Basque Country, Spain.
LA  - eng
SI  - ClinicalTrials.gov/NCT02796417
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20180306
PL  - England
TA  - J Psychiatr Res
JT  - Journal of psychiatric research
JID - 0376331
SB  - IM
MH  - Activities of Daily Living
MH  - Adult
MH  - Cognitive Dysfunction/etiology/*physiopathology/*rehabilitation
MH  - Cognitive Remediation/*methods
MH  - Emotional Intelligence/physiology
MH  - Executive Function/*physiology
MH  - Female
MH  - Humans
MH  - Male
MH  - Memory, Short-Term/physiology
MH  - *Outcome Assessment, Health Care
MH  - Schizophrenia/complications/*rehabilitation
MH  - *Social Perception
MH  - Theory of Mind/physiology
MH  - Verbal Learning/physiology
OTO - NOTNLM
OT  - Cognitive rehabilitation
OT  - Functional disability
OT  - Neurocognition
OT  - REHACOP
OT  - Schizophrenia
EDAT- 2018/03/12 06:00
MHDA- 2019/09/03 06:00
CRDT- 2018/03/12 06:00
PHST- 2017/11/29 00:00 [received]
PHST- 2018/01/24 00:00 [revised]
PHST- 2018/03/04 00:00 [accepted]
PHST- 2018/03/12 06:00 [pubmed]
PHST- 2019/09/03 06:00 [medline]
PHST- 2018/03/12 06:00 [entrez]
AID - S0022-3956(17)31304-3 [pii]
AID - 10.1016/j.jpsychires.2018.03.002 [doi]
PST - ppublish
SO  - J Psychiatr Res. 2018 Jun;101:21-27. doi: 10.1016/j.jpsychires.2018.03.002. Epub 
      2018 Mar 6.