Cognitive Remediation for Adolescents With Mental Health Disorders: A Systematic Review and Meta-Analysis

The effects of cognitive remediation therapy (CRT) in adults with mental health disorders have been widely documented, but its effects in adolescents with mental health disorders remain poorly understood. This review aims to (1) determine the effects of CRT on cognition, symptoms and functioning for adolescents with mental health disorders and (2) evaluate the methodological quality of studies on CRT.

A systematic review and meta-analysis were conducted of randomised controlled trials of CRT involving adolescents with mental health disorders. Searches were conducted in databases for studies pertaining to CRT effects on cognition, social functioning and clinical symptoms. Methodological quality was assessed using the Clinical Trials Assessment Measure.

Fourteen studies (N = 14) were included, with 11 independent samples (k = 11, 592 participants). Participants had various mental health disorders. CRT showed a small significant effect on cognition (g = 0.14, p = 0.02), particularly on processing speed, working memory and episodic memory. No significant effects were found for clinical symptoms (g = 0.04, p = 0.58) and social functioning (g = 0.06, p = 0.39). Methodological quality of included studies was variable, ranging from poor to good quality.

Included studies showed a small significant effect of CRT on cognition, and non-significant effects on clinical symptoms and social functioning in adolescents with mental health disorders. The lack of effects may be partly explained by limitations in the methodology of included studies. A critical analysis of current studies is presented and recommendations of core techniques to consider for future CRT studies are discussed.