The Effectiveness of Cognitive Rehabilitation on Improving Cognitive Deficits (Attention and Memory) in Patients With Chronic Schizophrenia Based on Cognitive Levels

Abstract

Introduction: Cognitive deficits have been recognized as a core feature of schizophrenia, which is directly associated with the functional and social outcomes of this disorder. Cognitive remediation therapy aims to improve the deficits and the following outcomes. The purpose of this study was to investigate the effectiveness of cognitive remediation therapy on attention and working memory in two groups of patients with Schizophrenia (low cognitive deficit and moderate one). Methods: 30 hospitalized patients with schizophrenia were selected and divided into two different groups by clinical interview and the score obtained in the MoCA Patients with low cognitive deficits and moderate cognitive deficits evaluated by classic Stroop test, Continuous Performance Test (CPT), and N-Back test before and after the treatment. Both groups received cognitive remediation therapy by the method of Sholberg and Mateer (2001). This rehabilitation program in the treatment of patients with schizophrenia focuses on the cognitive abilities of memory and its elements, attention and dimensions of attention and executive function. The above rehabilitation program is prepared for individual or group implementation and its purpose is to repair cognitive deficits and skills through practice and training. The number of sessions of this program includes 16 sessions, and the instructions for each session are very specific. Each session takes an average of 30 to 45 minutes. Findings: The results showed that cognitive rehabilitation in both groups at the post-test level significantly (P≤0.05) improved cognitive performance in the areas of sustained attention, selective attention and working memory. Comparing the performance between the two groups, only a significant difference (P≤0.05) was observed between the two groups in the field of sustained attention. Conclusion: Based on the findings, it can be said that cognitive rehabilitation treatment improves patients' performance in selective attention, sustained attention and working memory. In addition, in terms of the effectiveness of cognitive rehabilitation between the two groups with low and moderate cognitive deficits, the findings indicate more progress in the group with more severe cognitive deficits in the field of sustained attention and no difference in terms of progress in selective attention performance and working memory.