Department of Psychology, Faculty of Health Sciences, University of Deusto, Avda. Universidades 24, Bilbao 48007, Spain.
Department of Psychology, Faculty of Health Sciences, University of Deusto, Avda. Universidades 24, Bilbao 48007, Spain.
Psychiatry Res. 2023 Nov;329:115495. doi: 10.1016/j.psychres.2023.115495. Epub 2023 Sep 23.
Cognitive remediation is an effective intervention for improving functional outcome in schizophrenia. However, the factors that moderate this improvement are still poorly understood. The study aimed to identify moderators of functional outcome improvement after integrative cognitive remediation (REHACOP) in schizophrenia. This was a secondary analysis of data from two randomized controlled trials, which included 182 patients (REHACOP group=94; active control group=88). Hierarchical regression analyses were conducted to identify moderators of functional outcome improvement. Two baseline level groups (low-level and high-level) were created to analyze the moderating role of this baseline level cluster using repeated measures ANCOVA. The REHACOP was effective regardless of participants' baseline level, but regression analyses indicated that the effectiveness on functional outcome was higher among those who were older, had fewer years in education, lower scores in baseline cognition and functional outcome, and more negative symptoms. Repeated measures ANOVA showed that the baseline level cluster influenced the improvement in functional outcome, with the low-level group showing greater improvements. The results reinforced the need to implement cognitive remediation programs more broadly as a treatment for schizophrenia in healthcare services. Furthermore, they provided evidence for the development of personalized cognitive remediation plans to improve benefits in different schizophrenia profiles.
认知康复是改善精神分裂症患者功能结局的有效干预措施。然而，其改善的调节因素仍知之甚少。本研究旨在确定精神分裂症综合认知康复（REHACOP）后功能结局改善的调节因素。这是两项随机对照试验数据的二次分析，共纳入 182 名患者（REHACOP 组=94；积极对照组=88）。采用分层回归分析确定功能结局改善的调节因素。创建了两个基线水平组（低水平和高水平），使用重复测量方差分析（ANCOVA）分析该基线水平聚类的调节作用。REHACOP 无论参与者的基线水平如何都有效，但回归分析表明，基线认知和功能结局得分较低、负面症状较多、年龄较大、受教育年限较少的患者，其功能结局的改善效果更高。重复测量方差分析表明，基线水平聚类影响功能结局的改善，低水平组的改善程度更大。结果强化了在医疗保健服务中更广泛地实施认知康复计划作为精神分裂症治疗的必要性。此外，它们为制定个性化认知康复计划提供了证据，以改善不同精神分裂症患者的获益。
