Efficacy of Repyflec Cognitive Remediation Group Training in Schizophrenia

Phase 4

Completed

Brief Summary: The purpose of this study was to develop an integrative intervention for schizophrenia taking into account previous efficacious therapies. Thus, our aim was to evaluate the efficacy of our cognitive remediation group training: Problem Solving and Cognitive Flexibility training (REPYFLEC), focused to improve neurocognition and functioning in schizophrenia patients. We hypothesized that training executive function and metacognition would allow us to achieve improvements in neurocognition, functioning and psychiatric symptoms of patients with schizophrenia.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Current acute illness exacerbation
Mental Retardation
Neurological disorder which impairs cognition
Currently participating in social skills training or cognitive remediation
Change of antipsychotic medication one month before the trial or during the 40 study weeks
Diagnosis of alcohol or drug dependence within 6 months of trial commencement.

Arm && Interventions

Group	Intervention	Description
REPYFLEC cognitive remediation training	Repyflec cognitive remediation training	REPYFLEC cognitive remediation as a Problem solving and Cognitive flexibility group training.
Leisure group	Repyflec cognitive remediation training	Leisure group is a stimulating activity focused on socialization through group dynamics, board games, "coffee and talk".

Primary Outcome Measures

Name	Time	Method
Executive Function	Change from baseline in executive functioning at 40 weeks	Behavioral Assessment of the Dysexecutive Syndrome (BADS) (Wilson et al., 1996). This scale evaluates cognitive flexibility, inhibition of impulsive responses, planning and organization, working memory and time-estimation capacity. All subscales (Rule shift cards, Action Program, Key search, Temporal judgement, Zoo map and Six elements) were administered. We used subscales raw scores which run from 0 to 4. The subscales' raw score is summarized and converted to standardized total score which run (min. 12-max. 129). A higher score indicates better performance.

Secondary Outcome Measures

Name	Time	Method
Psychosocial Functioning	Change from baseline in social functioning scales at 40 weeks	The Spanish validation of the Life Skills Profile (LSP)was used. This scale measures functionality in daily life activities such as self-care, social behavior and autonomy. Raw scoring was used for the various subscales which are summarized for the total (min. 39-max. 156) with a higher score indicating a better result. The 5 subscales are: Self-care, Non-turbulence, Social contact, Communication and Responsibility. We used the Spanish validation of the Social Functioning Scale (SFS)for measuring social behavior and relationships, autonomy, employment-occupation and leisure. Raw scoring was used for each subscale and for total score (min. 0-max. 223) with a higher score indicating a better result. All 7 subscales were administered: social engagement/ withdrawal, interpersonal behavior, independence-competence, independence-performance, pro-social activities, recreation and employment/ occupation.
Psychiatric Symptoms	Change from baseline in psychiatric symptoms scales at 40 weeks	The Spanish validation of the Positive and Negative Syndrome Scale (PANSS) was used for measuring positive, negative and general symptomatology. Total raw scoring obtained through the sum of the raw scores for each subscale was considered (min. 30-max. 210) with a score of 30 representing an absence of psychiatric symptoms.