Objective:

Cognitive remediation provides substantial improvements in cognitive performance and real-world functioning for people living with schizophrenia, but the durability of these benefits needs to be reassessed and better defined. The aims of this study were to provide a comprehensive assessment of the durability of the benefits of cognitive remediation for cognition and functioning in people living with schizophrenia and evaluating potential moderators of effects.

Methods:

A systematic search was conducted in PubMed, Scopus, and PsycINFO, and reference lists of included articles and Google Scholar were inspected. Eligible studies were randomized clinical trials of cognitive remediation in patients diagnosed with schizophrenia spectrum disorders in which follow-up assessments were included. Screening and data extraction were performed by at least two independent reviewers. Cohen’s d was used to measure outcomes. Primary outcomes were changes in cognition and functioning from baseline to conclusion of follow-up. Moderators of the durability of effects were assessed.

Results:

Of 2,840 identified reports, 281 full texts were assessed and 130 reports on 67 studies with 5,334 participants were included. Cognitive remediation produced statistically significant positive effects that persisted at the end of follow-up in global cognition (d=0.23) and in global functioning (d=0.26). Smaller study samples and single-center studies were associated with better cognitive outcomes; longer treatment and follow-up duration, techniques for transferring cognitive gains to the real world, integration with psychiatric rehabilitation, group format of delivery, and more female participants in the sample were associated with better functional outcomes.

Conclusions:

Cognitive remediation provides durable improvements in cognition and functioning in schizophrenia. This finding corroborates the notion that cognitive remediation should be implemented more widely in clinical and rehabilitation practice.

中文翻译：

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认知矫正对精神分裂症认知和心理社会功能影响的持久性：随机临床试验的系统回顾和荟萃分析

客观的：

认知矫正可以显着改善精神分裂症患者的认知表现和现实世界功能，但这些益处的持久性需要重新评估和更好地定义。本研究的目的是全面评估认知矫正对精神分裂症患者认知和功能的益处的持久性，并评估影响的潜在调节因素。

方法：

在 PubMed、Scopus 和 PsycINFO 中进行了系统检索，并检查了所收录文章的参考文献列表和 Google Scholar。符合条件的研究是对诊断为精神分裂症谱系障碍的患者进行认知矫正的随机临床试验，其中包括随访评估。筛选和数据提取由至少两名独立评审员进行。Cohen's d 用于衡量结果。主要结果是从基线到随访结束的认知和功能的变化。评估了影响持久性的调节因素。

结果：

在 2,840 份已确定的报告中，评估了 281 份全文，并纳入了涉及 5,334 名参与者的 67 项研究的 130 份报告。认知矫正对整体认知（d=0.23）和整体功能（d=0.26）产生了统计上显着的积极影响，并在随访结束时持续存在。较小的研究样本和单中心研究与更好的认知结果相关；更长的治疗和随访时间、将认知收益转移到现实世界的技术、与精神康复的整合、小组分娩形式以及样本中更多的女性参与者都与更好的功能结果相关。

结论：

认知矫正可以持久改善精神分裂症的认知和功能。这一发现证实了认知矫正应该在临床和康复实践中更广泛地实施的观点。