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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.
The Journal of Nervous and Mental Disease
|July 8, 2016
Summary
Nearly half of psychosis patients adhered to computerized cognitive remediation (CR) therapy, even with minimal support. Poorer working memory and higher negative symptoms predicted better adherence to this crucial psychosis treatment.
Area of Science:
- Psychiatry and Behavioral Sciences
- Neuroscience
- Rehabilitation Medicine
Background:
- Cognitive remediation (CR) is a primary treatment for cognitive impairments in psychosis.
- Adherence rates and predictors for CR, especially with limited therapist support, are poorly understood.
- Computerized CR offers a scalable approach but requires investigation into patient engagement.
Purpose of the Study:
- To determine adherence rates to a computerized cognitive remediation program for psychosis.
- To identify factors predicting adherence in a clinical setting with minimal therapist support.
Main Methods:
- Sixty-one patients diagnosed with psychosis engaged in an 8-week computerized CR program.
- Adherence was defined by the percentage of prescribed training completed.
- Statistical analyses examined differences between adherent and nonadherent groups.
Main Results:
- 46% of participants completed a meaningful amount of cognitive remediation training.
- Patients with poorer working memory and higher negative symptom scores showed greater adherence.
- Significant cognitive deficits and negative symptoms did not hinder, and may have motivated, adherence.
Conclusions:
- Approximately half of psychosis patients can adhere to computerized CR with minimal therapist support.
- Cognitive deficits and negative symptoms are not barriers to adherence and may enhance motivation.
- Computerized CR is a viable treatment option for improving cognition in psychosis, even in low-support settings.
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