Evaluation of a cognitive strategy training in vocational rehabilitation of schizophrenic outpatients

Background: Cognitive dysfunctions in schizophrenia are one of the most important rate limiting factors concerning social and vocational role functioning and response to psychosocial intervention.. Objective: Effectivity of a computer assisted cognitive remediation program for schizophrenic outpatients (small group setting, 16 sessions over 8 weeks during vocational rehabilitation). The trained metacognitice skills focused deficits in attention, verbal memory and executive function: Methods: 59 DSM-IV-schizophrenic outpatients were alocated by random to one of two conditions, cognitive strategy training or control group. Stratification was done concerning type of neuroleptic treatment: conventional agents or atypical agents: Results: The cognitive remediation program was shown to be effective in the reduction of attentional deficits, gains in delayed recall, learning and executive functioning (working memory). Conclusions: The most important result was progress in learning ability (RAVLT) which points to expanding rehabilitation potential by cognitive remediation in schizophrenia. Generalization of effects on community functioning like social and vocational role functioning and stability of therapy outcome over time are still open questions which are hoped to be answered in data analyses of a current study for schizophrenic inpatients.