Harvard Mental Health Letter

Cognitive enhancement therapy for schizophrenia

Used early on, this hybrid therapy may improve mental and social functioning.

Difficulties in thinking and socializing, known as "negative" symptoms, often develop in patients with schizophrenia and typically persist even after hallucinations, delusions, and other "positive" symptoms of the disorder are under control. Various types of cognitive remediation therapies exist to improve mental and social functioning, but most have been studied only in patients with chronic schizophrenia.

In a study testing a cognitive intervention earlier in the schizophrenia disease process, researchers at the University of Pittsburgh published a series of papers about a randomized controlled trial evaluating a hybrid therapy, cognitive enhancement therapy, that combines cognitive remediation techniques with social skills training. The core study involved 58 young adult outpatients (the average age was 26) who were diagnosed either with schizophrenia or schizoaffective disorder. Patients had experienced their first psychotic symptom an average of three years prior to entry into the study; nearly 80% had been ill for fewer than five years. All had symptoms under control as the study began and continued taking their antipsychotic medications.

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