Web-based psychoeducational interventions for managing cognitive impairment-a systematic review.

Objective: Web-based rehabilitation, a branch of telerehabilitation, is carried out over the internet, unrestricted by time or place. Even though web-based interventions have been reported as feasible and effective in cases of mood disorders, for example, such evidence on the effectiveness of web-based cognitive rehabilitation remains unclear. This systematic review summarizes current knowledge on web-based psychoeducational programs aiming to manage cognitive deficits in patients with diseases that affect cognition. Methods: Using the Ovid database and the Web of Science, we systematically searched the Cochrane Database of Systematic Reviews, Medline, and PsycINFO to identify eligible studies. The review protocol (CRD42021257315) was pre-registered with the PROSPERO International Prospective Register of Systematic Reviews. The search was performed 10/13/2022. Two reviewers independently screened titles, abstracts, and full-texts, and extracted data for the selected studies. Two independent reviewers assessed the methodological quality. Results: The search retrieved 6,487 articles. Four studies with different patient groups (stroke, traumatic brain injury, brain tumor, and cancer) met the inclusion criteria of this systematic review. The studies examined systematic cognition-focused psychoeducational rehabilitation programs in which the patient worked independently. Three studies found positive effects on subjective cognitive functions, executive functions, and self-reported memory. No effects were found on objective cognitive functions. However, the studies had methodological weaknesses (non-randomized designs, small sample sizes, vaguely described interventions). Overall, adherence and patient satisfaction were good/excellent. Conclusion: Web-based cognitive intervention programs are a new approach to rehabilitation and patient education. The evidence, although scarce, shows that web-based interventions are feasible and support subjective cognitive functioning. However, the literature to date is extremely limited and the quality of the studies is weak. More research with high-quality study designs is needed. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=257315, identifier: CRD42021257315.

Associations of psychotic-like or manic-like experiences with later psychiatric disorders: An 11-year follow-up study of middle-aged adults.

Psychotic-like experiences (PLEs) and manic-like experiences (MLEs) have been found to be associated with elevated risk for future psychotic disorders. However, most follow-up studies have been conducted on adolescent and young adult samples leaving the predictive value of PLEs and MLEs among middle-aged subjects largely unknown. Here we report findings of an 11-year follow-up study of middle-aged subjects with PLEs (n=86) or MLEs (n=45) at baseline and population controls (n=62). We found that PLEs or MLEs at baseline did not predict conversion to psychosis during an 11-year follow-up in this age group. However, MLEs at baseline were associated with increased risk of nonpsychotic psychiatric disorders at follow-up whereas PLEs were not. Baseline neuropsychological performance was not associated with later psychiatric disorders in groups with PLEs or MLEs. In conclusion, our results suggest that among middle-aged subjects having PLEs or MLEs may not be a similar risk for future psychotic disorders as in younger age groups. However, studies with larger study groups and longer follow-up periods are needed in the future.