The relationship of cognitive improvement after cognitive remediation with social functioning in patients with schizophrenia and severe cognitive deficits

Background: This study aims to examine the effects of change in neurocognition on functional outcomes and to examine predictors of change in social functions following a 12-week course of cognitive remediation in patients with schizophrenia and schizoaffective disorder with severe cognitive impairments. Method: Level of social functioning was assessed using a performance based measure of functional capacity (PSP) in patients prior to and after the completion of 12-week cognitive remediation treatment (CRT). Participants completed a neuropsychological battery (MCCB-MATRICS) and clinical measures at both time points. Results: 63 subjects with a mean age of 41.4 (SD = 122) and with 122 years of education (SD = 2.4) were enrolled There were significant improvements in overall PSP score from baseline to endpoint (p = 0.021) as well as in PSP domain A (socially useful activities) (P <= 0.001), domain B (personal and social relationships) (p = 0.009), and domain D (disturbing and aggressive behaviors) (p = 0.003). There was a significant improvement in the composite MCCB score (p = 0.020) and the Working Memory (p < 0.046). Stepwise logistic regression yielded a significant association for baseline Visual Learning (Wald = 6.537, p = 0.011, OR = 1.195), Speed of Processing (Wald = 4.112, p = 0.043, OR = 0.850) and level of PANSS positive symptoms (Wald = 4.087, p = 0.043, OR = 0.739) with PSP overall improvement. Conclusions: Faster speed of processing, better visual and verbal leaming and less prominent positive symptoms were associated with greater functional improvement after a systematic cognitive intervention within a rehabilitative setting. (C) 2017 Elsevier B.V. All rights reserved.