O8.3. CONFIRMATORY EFFICACY OF COGNITIVE ENHANCEMENT THERAPY FOR EARLY SCHIZOPHRENIA: RESULTS FROM A MULTI-SITE RANDOMIZED TRIAL.

Background Schizophrenia is a chronic and disabling mental health condition. The early application of cognitive remediation interventions has provided some of the greatest hope of reducing long-term disability in the condition. Cognitive Enhancement Therapy (CET) is a particularly promising approach to cognitive remediation that integrates both computer-based neurocognitive training and structured social-cognitive groups. In 2009, Eack and colleagues demonstrated evidence that CET significantly improved cognitive and functional outcomes among individuals in the early course of schizophrenia (N = 58). The current study seeks to confirm these effects in the early course of the condition in a larger multi-site clinical trial. Methods A total of 106 (Pittsburgh: n = 54; Boston: n = 52) early course schizophrenia outpatients were randomized to either 18 months of CET (n = 61) or an Enriched Supportive Therapy (EST; n = 45) comparison treatment. Patients completed a comprehensive battery of cognitive, functional, and clinical assessments at baseline, 9 (mid-treatment), and 18 months (end of treatment). Composite indexes were calculated for neurocognition, social cognition, functional outcome, and symptomatology. Intent-to-treat linear mixed-effects models, adjusted for potential demographic and antipsychotic dose confounding effects, were used to investigate differential change trajectories in outcomes between CET and EST. The group (CET vs. EST) x time (baseline, 9, and 18 months) interaction was the effect of interest. Results No significant group x time interactions were observed for either neurocognition (F2,88 =.30, p =.742) or clinical symptoms (F2,88 =.13, p =.874). CET demonstrated particularly favorable effects on social cognition and functional outcomes. Over the 18 months of treatment, relative to the patients in the EST treatment group, those in CET had significantly greater linear gains in social-cognitive abilities (F2,88 = 3.62, p =.031, d =.64) and functional outcome (F2,88 = 4.18, p =.019, d =.37). Discussion These results support CET as an effective treatment for improving social cognitive and functional outcomes in the early course of schizophrenia, largely confirming the findings from the initial trial (Eack et al. 2009). Such evidence underscores the impact of CET on reducing disability when applied as an early course intervention. [ABSTRACT FROM AUTHOR]