Efficiency of cognitive rehabilitation with REHACOP in chronic treatment resistant Hispanic patients

Issue title: Spanish Speakers with Neurological and Psychiatric Disabilities: Relevant Factors Related to Rehabilitation

Guest editors: Juan Carlos Arango-Lasprilla

Article type: Research Article

Authors: Ojeda, N.^{a; b; *} | Peña, J.^a | Sánchez, P.^c | Bengoetxea, E.^a | Elizagárate, E.^{b; c; e} | Ezcurra, J.^c | Gutiérrez Fraile, M.^{b; c; d}

Affiliations: [a] Facultad de Psicología y Educación, Universidad de Deusto, Avda. Universidades, Bilbao, Spain | [b] CIBERSAM, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain | [c] Unidad de Psicosis Refractaria, Hospital Psiquiátrico de Alava, Alava, Vitoria, Spain | [d] Departamento de Neurociencias, Facultad de Medicina, Universidad de País Vasco, Leioa, Spain | [e] Servicio de Psiquiatría, Hospital Santiago, Vitoria, Spain | Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA

Correspondence: [*] Corresponding author: Natalia Ojeda, Facultad de Psicología y Educación, Universidad de Deusto, Avda. Universidades, 24, 48007 Bilbao, Spain. Tel.: + 34 94 413 90 00 Ext 2702; Fax: + 34 94 413 90 89; E-mail: nojeda@deusto.es

Abstract: 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.

Keywords: Chronic schizophrenia, treatment resistant, cognitive rehabilitation, Rehacop

DOI: 10.3233/NRE-2011-0728

Journal: NeuroRehabilitation, vol. 30, no. 1, pp. 65-74, 2012