Abstract

Objective

Negative symptoms and cognitive impairment in schizophrenia (SZ) remain unmet treatment needs as they are highly prevalent, associated with poor functional outcomes, and resistant to pharmacologic treatment. The current pilot randomized controlled trial examined the efficacy of an integrated Cognitive-Behavioral Social Skills Training and Compensatory Cognitive Training (CBSST-CCT) intervention compared to Goal-focused Supportive Contact (SC) on negative symptoms and cognitive performance.

Methods

Fifty-five adults with SZ or schizoaffective disorder with moderate-to-severe negative symptoms were randomized to receive 25 twice-weekly, 1-h manualized group sessions (12.5 weeks total duration) of either CBSST-CCT or SC delivered by master’s level clinicians in five community settings. Assessments of negative symptom severity (primary outcomes) and neuropsychological performance, functional capacity, social skills performance, and self-reported functional ability/everyday functioning, psychiatric symptom severity, and motivation (secondary outcomes) were administered at baseline, mid-treatment, post-treatment, and 6-month follow-up.

Results

Mixed-effects models using baseline, mid-treatment, and post-treatment data demonstrated significant CBSST-CCT-associated effects on negative symptom severity, as assessed by the Scale for the Assessment of Negative Symptoms (p = .049, r = 0.22), with improvements in diminished motivation driving this effect (p = .037, r = 0.24). The CBSST-CCT group also demonstrated improved verbal learning compared to SC participants (p = .026, r = 0.36). The effects of CBSST-CCT appeared to be durable at 6-month follow-up.

Conclusions

CBSST-CCT improved negative symptom severity and verbal learning in high-negative-symptom individuals relative to SC. CBSST-CCT warrants larger investigations to examine its efficacy in treating negative symptoms, along with other symptoms, cognition, and, ultimately, real-world functional outcomes. Clinical Trial registration number NCT02170051.

中文翻译：

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针对精神病负面症状的综合认知行为社交技能训练和补偿性认知训练：在试点随机对照试验中的效果

摘要

客观的

精神分裂症 (SZ) 中的阴性症状和认知障碍仍然未满足治疗需求，因为它们非常普遍，与较差的功能结果相关，并且对药物治疗有抵抗力。目前的试点随机对照试验检查了综合认知行为社交技能训练和补偿性认知训练 (CBSST-CCT) 干预与以目标为中心的支持性接触 (SC) 在负面症状和认知表现方面的效果。

方法

55 名患有中度至重度阴性症状的 SZ 或分裂情感障碍成人随机接受 25 次由硕士级临床医生提供的 CBSST-CCT 或 SC 每周 2 次、1 小时手动小组会议（总持续时间 12.5 周）在五个社区环境中。在基线、治疗中期、治疗后对阴性症状严重程度（主要结果）和神经心理表现、功能能力、社交技能表现和自我报告的功能能力/日常功能、精神症状严重程度和动机（次要结果）进行评估-治疗和6个月的随访。

结果

使用基线、治疗中期和治疗后数据的混合效应模型表明，CBSST-CCT 对阴性症状严重程度有显着影响，如阴性症状评估量表所评估的 ( p = .049, r = 0.22) ，随着减少的动机的改善推动了这种效果（p = .037，r = 0.24）。与 SC 参与者相比，CBSST-CCT 组也表现出改进的语言学习 ( p = .026, r = 0.36)。在 6 个月的随访中，CBSST-CCT 的效果似乎是持久的。

结论

相对于 SC，CBSST-CCT 改善了高阴性症状个体的阴性症状严重程度和语言学习。CBSST-CCT 需要进行更大规模的调查，以检查其在治疗阴性症状以及其他症状、认知以及最终的现实世界功能结果方面的功效。临床试验注册号 NCT02170051。