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Adherence to a Low-Support Cognitive Remediation Training Program for Psychosis
Rachael Dillon1, April Hargreaves, Heike Anderson-Schmidt
1*Department of Psychiatry, Trinity College Dublin, Dublin, Ireland; †Department of Psychiatry and Psychotherapy, University Medical Center, Georg-August University, Göttingen, Germany; ‡Trinity College Institute of Neuroscience and School of Psychology, Trinity College Dublin, Dublin; and §Neuroimaging and Cognitive Genomics Center, School of Psychology, National University of Ireland Galway, Galway, Ireland.
Abstract:
Cognitive remediation (CR) has emerged as the treatment of choice for impaired cognition in psychosis. However, little is known about adherence rates and factors predicting adherence to CR, particularly in clinical settings where high-level therapist support is unavailable. This study aimed to establish adherence rates and examine variables predicting adherence to a computerized CR program for psychosis (with minimal support). Patients with psychosis (n = 61) participated in an 8-week CR program. Results showed 46% completed a meaningful amount of CR training. The fully adherent (>80% of the prescribed amount) and nonadherent groups differed where adherent participants had poorer working-memory and higher negative symptom scores. These findings suggest that approximately half of the sample were adherent to treatment despite minimal therapist support. Furthermore, higher cognitive deficits and negative symptoms did not impede adherence, and may have contributed to patients' motivation to complete the program.
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