Introduction: Cognitive rehabilitation in schizophrenia has been proved to benefit cognition depending on the severity of the illness and the cognitive deficits. Nevertheless studies of efficiency with chronic patients, refractory to additional treatment interventions, have not yet been published.
Design: Ninety three patients with schizophrenia were recruited from the Treatment Resistant Schizophrenia Unit in Alava (Spain). All subjects underwent a baseline and a 3 months assessment including cognition, clinical symptoms and functional capacity. Patients were randomly assigned to receive either neuropsychological rehabilitation or occupational therapy for 3 months in addition to treatment as usual (TAU).
Results: Patients at the Rehacop group showed significantly greater improvements at 3 months in most areas of cognition evaluated including speed of processing, language, memory and executive functioning, compared to the occupational therapy group (group x time interactions p< 0.001). The Rehacop group also showed significant improvement in positive symptoms, functional and insight measures. Although data was not statistically significant, the Rehacop group showed a tendency to also improve negative symptoms compared to controls.
Conclusions: Despite to their limited respond to TAU, our data suggest that chronic refractory patients can improve their cognitive performance after neuropsychological rehabilitation with the Rehacop. These findings support the feasibility of integrating neuropsychological rehabilitation into TAU programs for patients with lower responses to other treatment plans.