Combining compensatory cognitive training and medication self-management skills training, in inpatients with schizophrenia: A three-arm parallel, single-blind, randomized controlled trial

Abstract

Objective: Cognitive impairment has a critical impact on functional outcomes in patients with schizophrenia. Compensatory cognitive training (CCT) has shown promise as a cognitive rehabilitation tool but little is known about its effectiveness when combined with medication self-management skills training (MSST) in patients with schizophrenia. Thus, this study compared the effects of a combined CCT and MSST with CCT and treatment as usual (TAU) on cognitive function, symptoms, and medication adherence.

Method: Eighty-seven inpatients with schizophrenia were randomly assigned to the TAU, CCT, or CCT + MSST groups. Assessments of cognitive function using the Brief Assessment of Cognition in Schizophrenia, symptoms using the Positive and Negative Syndrome Scale, and medication adherence using the Medication Adherence Questionnaire, were administered to all participants at baseline and at post-intervention.

Results: Compared with the TAU group, the CCT group had significant improvements in verbal fluency, total cognitive function and medication adherence, and the CCT + MSST group had significant improvements in verbal fluency, total cognitive function, positive symptoms, and medication adherence. Compared with the CCT group, the CCT + MSST group had significant improvements in total cognitive function.

Conclusions: These results indicate that the integrated intervention may be more advantageous than CCT alone in improving total cognitive function and positive symptoms. Future research should seek to further explore the long-term effects of such a joint intervention.

Keywords: Cognition disorders; Cognitive remediation; Medication adherence; Schizophrenia; Self-management.