Long-acting antipsychotic therapy plus cognitive training show promise for schizophrenia

FINDINGS

UCLA scientists and colleagues found the use of long-acting antipsychotic medication combined with the use of cognitive training in group settings led to improved cognition and increased productivity.

Researchers say patients using a combination of long-acting antipsychotic medication and a multipronged cognitive remediation that taught memory and problem-solving skills had significant improvements in work and school function.

BACKGROUND

Schizophrenia(Link is external) (Link opens in new window) is a serious mental illness that affects how a person thinks, feels and behaves. People with schizophrenia may appear to have lost touch with reality, which can cause distress for family and friends and lead to permanent disability. Treatments delivered in a sustained manner can help people with schizophrenia engage in school or work, achieve independence and enjoy personal relationships.

METHODS

During a 12-month randomized controlled trial, 60 patients from the UCLA Aftercare Program(Link is external) (Link opens in new window) who recently experienced a first episode of schizophrenia were randomized to oral or long-acting injectable antipsychotic medication and to either cognitive remediation or healthy behavior training. Cognitive remediation involved training in attention, memory, and problem-solving skills to help navigate complex, life-like situations. The healthy behavior training focused on nutrition, stress management, and exercise, with equal treatment time. All patients were provided supported employment and education to encourage return to work or school.

IMPACT

Systematic cognitive training, when combined with consistent antipsychotic medication adherence, achieved in this case through the use of a long-acting medication, can significantly improve cognitive deficits in the initial period of schizophrenia. These therapies show a separate significant impact on improving work and school functioning.

AUTHORS

UCLA researchers included: Keith Nuechterlein, Joseph Ventura, Kenneth Subotnik, Denise Gretchen-Doorly, Luana Turner, Laurie Casaus, John Luo, Michael Boucher and Jacqueline Hayata. Morris Bell of Yale University and Alice Medalia of Columbia University also collaborated in the study.

JOURNAL

The research is published(Link is external) (Link opens in new window) in the journal Psychological Medicine.

FUNDING

A grant from the National Institute of Mental Health funded this research.