The Effectiveness of Cognitive Rehabilitation on Improving Cognitive Deficits in Patients With Chronic Schizophrenia Based on Cognitive Levels

Abstract

Objectives Cognitive deficits are a core feature of schizophrenia, which are directly associated with the functional and social outcomes of this disorder. Cognitive remediation therapy aims to improve the deficits and the following outcomes. This study aimed to investigate the effectiveness of cognitive remediation therapy on attention and working memory of two groups of patients with schizophrenia (low and moderate cognitive deficit). Methods A total of 30 hospitalized patients with schizophrenia were selected and divided into two different groups by clinical interviews and the scores obtained in the montreal cognitive assessment (MoCA). The patients with low and moderate cognitive deficits were evaluated by the classic Stroop test, continuous performance test (CPT), and n-back test before and after the treatment. Both groups received cognitive remediation therapy prepared by Sholberg and Mateer (2001). This rehabilitation program in treating patients with schizophrenia focuses on the cognitive abilities of memory and its elements, attention, and dimensions of attention and executive function. The above rehabilitation program has been prepared for individual or group implementation, and its purpose is to repair cognitive deficits and skills through practice and training. The number of sessions of this program includes 16, and the instructions for each session are very specific. Each session takes an average of 30 to 45 minutes. Results The results showed that cognitive rehabilitation in both groups at the post-test level (P≤0.05) improved cognitive performance significantly in the areas of sustained attention, selective attention, and working memory. Comparing the performance between the two groups, only a significant difference (P≤0.05) was observed between the two groups in the field of sustained attention. Conclusion Based on the findings, cognitive rehabilitation treatment improves patients’ performance in selective attention, sustained attention, and working memory. In addition, in terms of the effectiveness of cognitive rehabilitation between the two groups with low and moderate cognitive deficits, the findings indicate more progress in the group with more severe cognitive deficits in the field of sustained attention and no difference in selective attention performance and working memory.