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Is cognitive remediation acceptable?

by Professor Antonio Vita, Chair of Psychiatry at University of Brescia, Italy

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Treatment acceptability is an important issue in all medical fields. Even the most effective treatments cannot be adopted in clinical practice if they pose excessive risks, if they are considered painful or have side effects that are hard to tolerate. Although psychosocial interventions do not have the same risks or side effects as surgical procedures or most pharmacological treatments, their acceptability is still important.


What if they are considered excessively tiring and time consuming, or even simply boring, by service users? What if some psychosocial interventions are more engaging and interesting, and therefore more accepted, than others?


We know that Cognitive Remediation for people living with schizophrenia benefits cognition and daily functioning (see a previous post, which can be read here). Following that finding the same authors wanted to explore acceptability in a meta-analysis that used the same studies (Vita et al, Psychol Med. 2023; 53(8):3661-3671). They defined acceptability as the rate that participants abandoned treatment. This meta-analysis included 151 studies and a total of 10 477 individuals and found that less than 17% of people participating in Cognitive Remediation programs abandoned the treatment before its conclusion. That’s less than half of what is usually observed for pharmacological treatments!


Cognitive Remediation programs were also not abandoned more often than their control conditions, that could be treatment as usual or other psychosocial interventions.


All this information led the Authors to conclude that Cognitive Remediation is not only benefits cognitive performance and daily functioning for people living with schizophrenia, but it is also well accepted by service users!


In light of these findings, Cognitive Remediation should be explicitly included in clinical guidance, and offering it in a consistent manner should become a clear objective for mental health services.


 

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