Integrative Cognitive Remediation (ICR) for patients with chronic schizophrenia: impact on neurocognitive symptoms and social functioning

Schizophrenia´s cognitive symptoms are a key therapeutic target because these are important predictors of the patient´s ability to function in the community. Recently, an Integrative Cognitive Remediation (ICR) program has been developed for patients with early psychosis, that combines both a restorative approach and a compensatory approach, as well as social cognition training. We aimed to evaluate the feasibility and acceptability of implementing this program in a Global South setting for patients with chronic schizophrenia, and to explore its preliminary impact on cognitive symptoms and social functioning. In this pilot study, we recruited a sample of 16 patients, implemented a 12-week ICR program following previously published guidelines, and assessed feasibility, acceptability, as well as changes in cognition and functioning. The implementation of this ICR program was feasible and well appreciated by our patients with chronic schizophrenia. Their favorable subjective reported experiences were matched by significant changes in Global cognition (+ 2.6 points in MCCB Global Cognition T Score, p < 0.05; +2.5 points in MoCA, p < 0.04 ) and social functioning (+3.6 points in SFS, p < 0.049). However, these findings need to be confirmed by a larger ICR study in chronic schizophrenia patients, in a controlled randomized trial that includes a control group.