A cognitive remediation training for young adults with psychotic disorders to support their participation in education - study protocol for a pilot randomized controlled trial

Lana K M Otto; Jacomijn Hofstra; Michelle G Mullen; Derek Malenczak; Nynke Boonstra; Lisette van der Meer; Wim Veling; Cees Boerhout; Gerard D van Rijsbergen; Jos de Vries; Boudien van der Pol; Gerdina H M Pijnenborg; Lies Korevaar

doi:10.1186/s40814-020-00579-0

A cognitive remediation training for young adults with psychotic disorders to support their participation in education - study protocol for a pilot randomized controlled trial

Pilot Feasibility Stud. 2020 Apr 27:6:54. doi: 10.1186/s40814-020-00579-0. eCollection 2020.

Authors

Lana K M Otto^{1

2}, Jacomijn Hofstra¹, Michelle G Mullen³, Derek Malenczak⁴, Nynke Boonstra^{5

6}, Lisette van der Meer^{7

8

9}, Wim Veling¹⁰, Cees Boerhout¹⁰, Gerard D van Rijsbergen¹¹, Jos de Vries¹⁰, Boudien van der Pol⁵, Gerdina H M Pijnenborg^{2

11}, Lies Korevaar¹

Affiliations

¹ 1Research and Innovation Center for Rehabilitation, Hanze University of Applied Sciences, Zernikeplein 23, 9747 AS Groningen, The Netherlands.
² 2Faculty of Behavioural and Social Sciences, Department of Clinical Psychology & Experimental Psychopathology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands.
³ 3Transitions to Adulthood Center for Research, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA 01545 USA.
⁴ 4Department of Psychiatric Rehabilitation and Counseling Professions, School of Health Professions, Rutgers University, 675 Hoes Lane West, Piscataway, NJ 08854 USA.
⁵ Department of Research and Education, Friesland Mental Health Services, PO Box 932, 8901 BS Leeuwarden, The Netherlands.
⁶ NHL Stenden University of Applied Science, Research group Care & Welfare, Rengerslaan 8, 8917 DD Leeuwarden, The Netherlands.
⁷ 7Department of Rehabilitation, Lentis Psychiatric Institute, E 035, 9471 KA, Zuidlaren, The Netherlands.
⁸ 8Rob Giel Research Center, University Medical Center Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands.
⁹ 9Faculty of Behavioural and Social Sciences, Department of Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands.
¹⁰ 10University Center for Psychiatry, University Medical Center Groningen, University of Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands.
¹¹ 11GGz Drenthe Mental Health Institution, Dennenweg 9, 9404 LA Assen, The Netherlands.

Abstract

Background: Most severe mental disorders have their onset between the age of 17 and 27, a time when many young adults begin participating in secondary or post-secondary education. The cognitive deficits typically associated with psychiatric disorders, especially psychotic disorders, increase the risk of leaving school early, which can lead to a reduction in employment opportunities later on in life and, in turn, a poorer long-term prognosis. Therefore, specific interventions aiming to improve these cognitive functions are needed. Cognitive remediation (CR) aims to improve cognitive functioning and may increase real-world functioning in educational performance. This study aims to examine the feasibility and applicability of a CR training named Mindset for students with psychotic disorders in the Netherlands.

Methods/design: Sixty students diagnosed with a psychotic disorder and currently reporting cognitive deficits will be included from four Dutch Mental Health Care institutes. Half of the participants (N = 30) will be randomly assigned to the CR training consisting of twelve, individual, weekly 1-h meetings. The other half will be assigned to an active control condition consisting of twelve weekly assignments that will be sent by email aiming to improve school performance. Students will be evaluated at baseline (T0), directly after finishing the CR training or control intervention (T1), and 6 months later (T2). Treatment feasibility will be the primary outcome, using evaluation forms, interviews with trainers and participants, number of study drop outs, and patient eligibility and recruitment rates. School functioning, cognitive functioning, and strategy use will also be assessed to get a preliminary idea of the potential effectiveness of the intervention.

Discussion: The CR training in this study will provide real-world examples and exercises aimed to teach useful strategies to cope with the cognitive deficits experienced by students with psychotic disorders. Furthermore, since students with other psychiatric disorders might also experience cognitive deficits, the results of this study may also provide some further implications for future studies on the effect of this CR training for students with these disorders.

Trial registration: The study was registered with Trialregister.nl, no. NL6590 (NTR6764), date registered: September 7, 2017. Register name: Mindset. A cognitive rehabilitation training for young adults with psychotic spectrum disorder in an educational setting: A pilot study.Protocol version: 3, date December 23, 2019.

Keywords: Cognitive remediation; Education; Psychotic disorders; School performance; Young adults.