Cognitive Training and Remediation in First-Episode Psychosis: A Literature Review.
Kathleen Miley, Niloufar Hadidi, Merrie Kaas and 1 others
PMID 31578909WHAT IT FOUND
Cognitive training improved thinking skills in most studies of first-episode psychosis, but rarely translated to better daily functioning.
Effects on social skills were inconsistent, and long-term functional gains were not sustained.
Key findings
01Cognitive training showed positive effects on cognition in eight of nine studies reporting this outcome.
02The majority of studies failed to find differences between cognitive training and control groups for functional outcomes.
03None of the four studies with follow-up assessments found an effect on functioning at the later time point.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included only 10 studies, limiting the power to detect small effects or draw firm conclusions. Study quality was generally fair to poor, with high risk of bias due to insufficient blinding and incomplete outcome reporting. Interventions were highly heterogeneous in theoretical basis, dosing, and delivery, making it difficult to compare results or identify the most effective protocols. Generalizability is limited by the lack of diverse racial samples and the predominance of male participants. Few studies included follow-up assessments, so long-term effects on functioning are largely unknown.
Declared interests
The paper is supported by N.I.H. and non-U.S. government research grants. No specific conflicts of interest regarding commercial products or authors' financial ties to intervention providers are detailed in the provided text.
The easy way to misread this
Do not interpret the improvements in cognitive test scores as evidence that patients' daily functioning or social recovery will improve. The review found that most studies showed no significant difference in functional outcomes, and long-term functional gains were not sustained.