Thibaudeau Elisabeth, Bowie Christopher R, Montreuil Tina, Baer Larry, Lecomte Tania, Joober Ridha, Abdel-Baki Amal, Jarvis G Eric, Margolese Howard C, De Benedictis Luigi, Schmitz Norbert, Malla Ashok K, Lepage Martin
Prevention and Early Intervention Program for Psychoses, Douglas Mental Health University Institute, Montreal, 6875 Bd LaSalle, Verdun, Quebec, H4H 1R3, Canada; Department of Psychiatry, McGill University, Ludmer Research & Training Building, 1033 Pine Avenue West, Montreal, Quebec, H3A 1A1, Canada.
Department of Psychology, Department of Psychiatry, Centre for Neuroscience Studies, Queen's University, 62 Arch Street, Kingston, Ontario, K7L 3N6, Canada.
Psychiatry Res. 2024 Dec;342:116243. doi: 10.1016/j.psychres.2024.116243. Epub 2024 Oct 21.
Social anxiety disorder (SAD) is a frequent comorbidity in first-episode psychosis (FEP) and may increase cognitive impairments. Cognitive remediation (CR) is an effective treatment for cognition, particularly in a group format. This study aims to assess the efficacy, acceptability and engagement of group CR on cognitive outcomes in FEP+SAD compared to group cognitive-behavioral therapy (CBT). Participants with FEP+SAD were randomized to group CR (n = 45) or CBT-SAD (n = 51). They were assessed for cognition at baseline, post-therapy and 3- and 6-month follow-up. The CR group additionally completed scale to assess perceived competency and enjoyment in CR. Linear mixed models for repeated measures were used for cognitive scores. Descriptive statistics and t-tests were used to summarize acceptability, perceived competency, and enjoyment, for CR completers and non-completers. The CR group performed significantly better than CBT on executive functions and visual memory at post-therapy compared to baseline. Twenty participants completed CR (44 %; mean 5.5 sessions). At week 1, CR non-completers presented higher levels of perceived competency. Completers reported higher enjoyment scores at the last session compared to the first session. Group CR is effective for cognitive outcomes in FEP+SAD, but acceptability and engagement present a challenge. Future studies are necessary to explore approaches promoting engagement.
社交焦虑障碍（SAD）是首发精神病（FEP）中常见的共病情况，可能会加重认知障碍。认知康复（CR）是一种有效的认知治疗方法，尤其是采用小组形式时。本研究旨在评估与小组认知行为疗法（CBT）相比，小组CR对FEP+SAD患者认知结果的疗效、可接受性和参与度。将FEP+SAD患者随机分为小组CR组（n = 45）或CBT-SAD组（n = 51）。在基线、治疗后以及3个月和6个月随访时对他们进行认知评估。CR组还完成了评估对CR的感知能力和享受程度的量表。对认知分数采用重复测量的线性混合模型。使用描述性统计和t检验来总结CR完成者和未完成者的可接受性、感知能力和享受程度。与基线相比，CR组在治疗后执行功能和视觉记忆方面的表现明显优于CBT组。20名参与者完成了CR（44%；平均5.5次治疗）。在第1周，CR未完成者的感知能力水平较高。完成者报告在最后一次治疗时的享受得分高于第一次治疗。小组CR对FEP+SAD患者的认知结果有效，但可接受性和参与度存在挑战。未来有必要开展研究探索促进参与度的方法。
