Personalised treatment for cognitive dysfunction in individuals with schizophrenia spectrum disorders.
Alice Medalia, Alice M Saperstein, Marie C Hansen and 1 others
PMID 27219068WHAT IT FOUND
For schizophrenia spectrum disorders, matching cognitive remediation to baseline auditory processing may matter: patients with impaired auditory processing showed more cognitive and functional benefit from sensory training, while those without impairment did not.
This is pilot evidence, not a proven treatment.
Key findings
01The paper reviews evidence that cognitive remediation can produce group-level cognitive and functional effects, but more than 25% of treated patients do not improve.
02In a pilot of 34 outpatients, those with impaired baseline auditory tone matching had greater cognitive and functional benefit when cognitive remediation included sensory processing training.
03Patients with intact baseline auditory tone matching did not show added benefit from sensory processing training.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The article is a narrative review, not a systematic review, so it does not report a comprehensive search or formal appraisal of all relevant studies. The pilot was small and tested only the auditory tone-matching variable. The benefit was seen in a subgroup, so it does not show that personalised cognitive remediation works for all patients with schizophrenia spectrum disorders. The pilot results are not replicated in this paper, and the authors call for further investigation. The authors disclosed commercial consulting fees and royalties.
Declared interests
Dr Medalia disclosed a royalty from Oxford University Press and consulting fees from Takeda Pharmaceuticals, Forum Pharmaceuticals, and Dainippon Sumitomo Pharma Inc. All other authors reported no financial disclosures.
The easy way to misread this
Do not change cognitive remediation practice based on this paper. The promising subgroup result comes from a small pilot and a review of previous studies, so it is not evidence that personalised cognitive remediation works for all patients with schizophrenia spectrum disorders.