Cognitive remediation improves cognition and good cognitive performance increases time to relapse--results of a 5 year catamnestic study in schizophrenia patients.

BACKGROUND: Cognitive deficits are stable features of schizophrenia that are linked to functional outcome. Cognitive remediation approaches have been proven successful in ameliorating these deficits, although effect sizes vary considerably. Whether cognitive deficits are serious predictors of clinical outcome is less clear. METHODS: Sixty patients suffering from schizophrenia were included in our sample, thirty of them received computer-assisted cognitive training, and thirty received occupational therapy. For a subsample of 55 patients, who could be traced over a period of five years after the end of the cognitive remediation intervention, time until first relapse and time in psychosis were determined retrospectively from their medical records. RESULTS: Cognitive remediation significantly improved problem solving, memory and attention with high effect sizes. Employment status, a post test verbal memory performance measure and a measure of executive functioning outperformed all other measures in the prediction of time to relapse, while allocation to treatment group outperformed all other variables in the prediction of both cognitive measures. CONCLUSIONS: Cognitive remediation of neurocognitive deficits thus makes sense in a twofold fashion: It enhances cognition directly and positively acts on clinical course indirectly via improved neurocognition. TRIAL REGISTRATION: German Clinical Trials Register: DRKS00004880.

Comorbidity of Tourette's syndrome and schizophrenia--biological and physiological parallels.

The authors report on five patients who first developed Tourette's syndrome (TS) and later schizophrenia with the typical positive and negative symptoms; all five had an unfavorable course of schizophrenia. These observations as well as other reported cases raise the question of whether both disorders may share a common background. This is discussed under the aspects of similar symptomatology (echolalia, motor symptoms, cognitive deficits, obsessive-compulsive symptoms), similar pathophysiological signs, genetics and signs of an underlying inflammatory process in subgroups of cases, as well as common therapeutic strategies. A genetically determined susceptibility could possibly underlie both disorders, e.g., an autoimmunologically triggered inflammation or a common pathophysiology of certain symptoms. Both disorders show disturbances of the multiple functional pathways, which seem to be involved in the pathophysiology of both. The clinical overlap of TS and of schizophrenia may be due to a final common pathophysiological pathway.

[Performance improvement and compliance of schizophrenic patients participating in the computerbased cognitive training with X-Cog]. / Leistungsfortschritte und Compliance schizophrener Patienten bei der Teilnahme am computergestützten kognitiven Training mit der Software X-Cog.

This study aimed to examine performance improvement and compliance of schizophrenic patients participating in computerbased cognitive training with X-Cog(R). 20 patients (5 women, 15 men) with the diagnosis of schizophrenia (ICD10 F20.X) were trained ten weeks (twice a week, duration 1h) using the software X-Cog(R) in different wards of the Bezirksklinikum Regensburg. After the evaluation of the feedback given by the computer it could be demonstrated that the patients showed marked practice improvements. Moreover it appeared very less leisure hours what could be shown by an evaluation of the regularity of participation. This study gives first indications that X-Cog(R) could be a useful way to increase individual performance, motivation and especially the continuity of participation in a therapy of schizophrenic patients training using a computerbased cognitive training software.