Feasibility of Providing Cognitive Remediation to People With Schizophrenia in a Clinical Network

NCT ID: NCT00930150

Last Updated: 2011-04-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

52 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-07-31

Study Completion Date

2010-02-28

Brief Summary

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This study will test whether a cognitive remediation program to treat people with schizophrenia can be successfully implemented in a network of research clinics.

Detailed Description

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Neurocognitive impairments, or problems with thinking and brain function, are a core component of schizophrenia. Such impairments, which can range from moderate to severe, are strongly associated with decreased benefit from psychiatric rehabilitation and problems with treatment adherence, socialization, employment, quality of life, and relapse. Researchers believe that the failure of medication to improve cognition may occur because medication treatment lacks cognitive stimulation. Cognitive remediation programs are a way to provide that stimulation, and they have shown moderate efficacy in improving cognition in people with schizophrenia. Implementing these cognitive remediation programs as part of schizophrenia treatment has occurred only at individual sites with highly trained research personnel. This study will test whether cognitive remediation programs for schizophrenia can be feasibly implemented at a network of sites that do not specialize in cognitive remediation research. This pilot study will gather preliminary efficacy data, but a larger study is required to draw definitive conclusions about treatment effects.

Participation in this study will last approximately 8 weeks. Participants will be randomly assigned to the Posit Science intervention group or the control group. Those in the Posit Science group will receive targeted cognitive training (TCT)-40 hours of adaptive computer exercises-and participate in a weekly bridging group that helps participants apply cognitive skills to everyday contexts. Length of the TCT may vary, depending on the availability of participants to complete the exercises. Those in the control group will play commercially available video games for the same number of hours and participate in a weekly health and wellness group. All participants will undergo assessments at baseline, mid-treatment, and post-treatment. Assessments will include self-report questionnaires and clinical interviews.

Conditions

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Schizophrenia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Posit Science Intervention

Participants will receive targeted cognitive training and participate in a bridging group.

Group Type EXPERIMENTAL

Targeted cognitive training

Intervention Type BEHAVIORAL

Adaptive computer exercises that systematically increase in task difficulty as each participant's performance ability improves

Bridging groups

Intervention Type BEHAVIORAL

Weekly group meetings that help participants apply their cognitive skills to everyday functioning, promote group identity, and promote socialization

Control

Participants will play commercially available computer games and participate in weekly groups to discuss health and wellness.

Group Type ACTIVE_COMPARATOR

Computer control

Intervention Type BEHAVIORAL

Commercially available computer games selected based on quality, ability to hold interest, and lack of disturbing content

Health and wellness groups

Intervention Type BEHAVIORAL

Weekly group meetings that teach participants health and wellness skills

Interventions

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Targeted cognitive training

Adaptive computer exercises that systematically increase in task difficulty as each participant's performance ability improves

Intervention Type BEHAVIORAL

Computer control

Commercially available computer games selected based on quality, ability to hold interest, and lack of disturbing content

Intervention Type BEHAVIORAL

Bridging groups

Weekly group meetings that help participants apply their cognitive skills to everyday functioning, promote group identity, and promote socialization

Intervention Type BEHAVIORAL

Health and wellness groups

Weekly group meetings that teach participants health and wellness skills

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Demonstrates adequate decisional capacity to make a choice about participating in the research study
* Diagnosis of schizophrenia or schizoaffective disorder, as defined by DSM-IV-TR criteria and confirmed by the Structured Clinical Interview for DSM-IV (SCID)
* Positive and Negative Syndrome Scale (PANSS) hallucinatory behavior, unusual thought content, and conceptual disorganization ratings of no greater than moderately severe (i.e., item scores must be less than or equal to 5)
* Meets all of the following cognitive performance and English language criteria:

1. Learned English before age 12
2. Able to complete the baseline Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) validly, based on the judgment of the investigator
3. Raw score of 37 or greater on the Wide Range Achievement Test, reading subtest, 3rd edition (WRAT-3), used to establish minimum sixth grade reading level and estimated premorbid IQ
* Able to state specific goals relevant to the intervention that participant would like to achieve
* Able to participate in the computerized intervention, based on the judgment of the investigator

Exclusion Criteria

* Psychiatric hospitalization within 8 weeks of random assignment
* Adjustment to antipsychotic treatment within 4 weeks of random assignment
* Currently taking an anticholinergic medication
* DSM-IV diagnosis of alcohol or substance abuse (other than nicotine) within the last month or a DSM-IV diagnosis of alcohol or substance dependence (other than nicotine) within the last 6 months
* History of mental retardation, pervasive developmental disorder, or other neurological disorder (such as a traumatic brain injury, epilepsy, or Parkinson 's disease)
Minimum Eligible Age

18 Years

Maximum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Mental Health (NIMH)

NIH

Sponsor Role lead

Responsible Party

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University of North Carolina at Chapel Hill

Principal Investigators

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Richard Keefe, PhD

Role: PRINCIPAL_INVESTIGATOR

Duke University

T. Scott Stroup, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

Columbia University

Locations

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Yale University/Connecticut Mental Health Center

New Haven, Connecticut, United States

Site Status

Emory University

Atlanta, Georgia, United States

Site Status

Medical College of Georgia

Augusta, Georgia, United States

Site Status

University of Iowa Hospital

Iowa City, Iowa, United States

Site Status

University of Massachusetts

Worcester, Massachusetts, United States

Site Status

University of Minnesota School of Medicine

Minneapolis, Minnesota, United States

Site Status

The University of North Carolina

Chapel Hill, North Carolina, United States

Site Status

Philadelphia VA Medical Center-116A

Philadelphia, Pennsylvania, United States

Site Status

University of Texas Health Science Center at San Antonio

San Antonio, Texas, United States

Site Status

Countries

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United States

References

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Roberts MT, Lloyd J, Valimaki M, Ho GW, Freemantle M, Bekefi AZ. Video games for people with schizophrenia. Cochrane Database Syst Rev. 2021 Feb 4;2(2):CD012844. doi: 10.1002/14651858.CD012844.pub2.

Reference Type DERIVED
PMID: 33539561 (View on PubMed)

Georgiades A, Davis VG, Atkins AS, Khan A, Walker TW, Loebel A, Haig G, Hilt DC, Dunayevich E, Umbricht D, Sand M, Keefe RSE. Psychometric characteristics of the MATRICS Consensus Cognitive Battery in a large pooled cohort of stable schizophrenia patients. Schizophr Res. 2017 Dec;190:172-179. doi: 10.1016/j.schres.2017.03.040. Epub 2017 Apr 20.

Reference Type DERIVED
PMID: 28433500 (View on PubMed)

Keefe RS, Vinogradov S, Medalia A, Buckley PF, Caroff SN, D'Souza DC, Harvey PD, Graham KA, Hamer RM, Marder SM, Miller DD, Olson SJ, Patel JK, Velligan D, Walker TM, Haim AJ, Stroup TS. Feasibility and pilot efficacy results from the multisite Cognitive Remediation in the Schizophrenia Trials Network (CRSTN) randomized controlled trial. J Clin Psychiatry. 2012 Jul;73(7):1016-22. doi: 10.4088/JCP.11m07100. Epub 2012 May 15.

Reference Type DERIVED
PMID: 22687548 (View on PubMed)

Other Identifiers

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N01-MH090001-07

Identifier Type: -

Identifier Source: secondary_id

PCC: DSIR AT

Identifier Type: -

Identifier Source: secondary_id

N01MH090001

Identifier Type: NIH

Identifier Source: secondary_id

View Link

N01 MH090001-07

Identifier Type: -

Identifier Source: org_study_id

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