A systematic review of moderators of cognitive remediation response for people with schizophrenia
Background: There is evidence that cognitive remediation (CR) is moderately effective in improving cognitive and functional difficulties in people with schizophrenia. However, there is still a limited understanding of what influence different treatment responses. Aim: To identify moderators influenc...
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doaj-6817d36cae67408185d81c9bd1a67be22020-11-25T01:24:53ZengElsevierSchizophrenia Research: Cognition2215-00132020-03-0119A systematic review of moderators of cognitive remediation response for people with schizophreniaBenedetta Seccomandi0Dimosthenis Tsapekos1Katie Newbery2Til Wykes3Matteo Cella4Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK; Corresponding author at: Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK.Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UKDepartment of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK; South London & Maudsley NHS Foundation Trust, Maudsley Hospital, London SE5 8AZ, UKDepartment of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK; South London & Maudsley NHS Foundation Trust, Maudsley Hospital, London SE5 8AZ, UKDepartment of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK; South London & Maudsley NHS Foundation Trust, Maudsley Hospital, London SE5 8AZ, UKBackground: There is evidence that cognitive remediation (CR) is moderately effective in improving cognitive and functional difficulties in people with schizophrenia. However, there is still a limited understanding of what influence different treatment responses. Aim: To identify moderators influencing CR response in people with schizophrenia. Methods: This systematic review follows PRISMA guidelines. Searches were conducted up to January 2019 on PubMed and PsychInfo to identify randomized controlled trials of CR reporting analyses of moderators of treatment response. All papers were assessed for methodological quality and information on sample size, intervention and control condition, moderators, outcomes, effect of moderator on outcomes and demographic characteristics from each study was extracted and critically summarised. Results: Thirty-six studies were included, considering 2737 participants. Study participants consisted on average of people in their late-thirties, mostly men, with over 10 years of illness. The review identified moderators that could be grouped into five categories: demographics, biological, cognitive and functional, psychological, and illness-related characteristics. The assessment of methodological quality showed that many studies had a high risk of bias. Conclusions: There was no high-quality replicated evidence which identifies reliable moderators of CR response. Many moderators were not replicated or presented in single, underpowered studies. Studies also investigated moderators independently despite their potential to overlap (e.g. age and education). Future research should concentrate on evaluating, with sound studies, the role moderators may play in affecting CR treatment response. This information can inform who will benefit most from the therapy and help to improve the benefits of CR. Keywords: Cognitive remediation, Cognition, Moderator, Schizophrenia, Psychosishttp://www.sciencedirect.com/science/article/pii/S2215001319300162 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Benedetta Seccomandi Dimosthenis Tsapekos Katie Newbery Til Wykes Matteo Cella |
spellingShingle |
Benedetta Seccomandi Dimosthenis Tsapekos Katie Newbery Til Wykes Matteo Cella A systematic review of moderators of cognitive remediation response for people with schizophrenia Schizophrenia Research: Cognition |
author_facet |
Benedetta Seccomandi Dimosthenis Tsapekos Katie Newbery Til Wykes Matteo Cella |
author_sort |
Benedetta Seccomandi |
title |
A systematic review of moderators of cognitive remediation response for people with schizophrenia |
title_short |
A systematic review of moderators of cognitive remediation response for people with schizophrenia |
title_full |
A systematic review of moderators of cognitive remediation response for people with schizophrenia |
title_fullStr |
A systematic review of moderators of cognitive remediation response for people with schizophrenia |
title_full_unstemmed |
A systematic review of moderators of cognitive remediation response for people with schizophrenia |
title_sort |
systematic review of moderators of cognitive remediation response for people with schizophrenia |
publisher |
Elsevier |
series |
Schizophrenia Research: Cognition |
issn |
2215-0013 |
publishDate |
2020-03-01 |
description |
Background: There is evidence that cognitive remediation (CR) is moderately effective in improving cognitive and functional difficulties in people with schizophrenia. However, there is still a limited understanding of what influence different treatment responses. Aim: To identify moderators influencing CR response in people with schizophrenia. Methods: This systematic review follows PRISMA guidelines. Searches were conducted up to January 2019 on PubMed and PsychInfo to identify randomized controlled trials of CR reporting analyses of moderators of treatment response. All papers were assessed for methodological quality and information on sample size, intervention and control condition, moderators, outcomes, effect of moderator on outcomes and demographic characteristics from each study was extracted and critically summarised. Results: Thirty-six studies were included, considering 2737 participants. Study participants consisted on average of people in their late-thirties, mostly men, with over 10 years of illness. The review identified moderators that could be grouped into five categories: demographics, biological, cognitive and functional, psychological, and illness-related characteristics. The assessment of methodological quality showed that many studies had a high risk of bias. Conclusions: There was no high-quality replicated evidence which identifies reliable moderators of CR response. Many moderators were not replicated or presented in single, underpowered studies. Studies also investigated moderators independently despite their potential to overlap (e.g. age and education). Future research should concentrate on evaluating, with sound studies, the role moderators may play in affecting CR treatment response. This information can inform who will benefit most from the therapy and help to improve the benefits of CR. Keywords: Cognitive remediation, Cognition, Moderator, Schizophrenia, Psychosis |
url |
http://www.sciencedirect.com/science/article/pii/S2215001319300162 |
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