Cognitive Training and Remediation in First-Episode Psychosis: A Literature Review

Area of Science:

• Psychiatry
• Neuroscience
• Cognitive Psychology

Background:

• Neurocognitive and social cognitive deficits are hallmarks of psychotic disorders, impacting individuals with first episode psychosis (FEP).
• These impairments significantly predict long-term social functioning difficulties.
• Cognitive training and remediation (CTR) offers a potential avenue for recovery-oriented treatment by addressing these cognitive deficits.

Purpose of the Study:

• To evaluate the theoretical underpinnings and intervention strategies of CTR for FEP.
• To examine the impact of CTR on cognitive and social functioning in individuals experiencing their first episode of psychosis.

Main Methods:

• A systematic review was conducted using databases like Ovid Medline, Embase, and Psych Info.
• The review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
• Quality and risk of bias were assessed using established methodologies.

Main Results:

• Ten randomized controlled trials (RCTs) of fair to poor quality were included.
• CTR interventions for FEP commonly target higher-order cognitive processes.
• Most studies reported improvements in at least one cognitive domain, particularly global cognition, verbal learning, memory, and executive functions.
• Functional outcomes showed improvement in only three studies.

Conclusions:

• Diverse CTR interventions demonstrate potential for ameliorating cognitive impairments in FEP.
• The evidence for functional benefits of CTR in FEP is less consistent.
• Future research should explore CTR targeting sensory/perceptual processes and identify specific targets and components for robust cognitive and functional gains.