An intervention combining cognitive-behavioral social skills training with compensatory cognitive training (CBSST-CCT) improved negative symptoms and verbal learning in adults with schizophrenia, according to a pilot study published in Schizophrenia Bulletin. 

“Negative symptoms and cognitive impairment in schizophrenia remain unmet treatment needs,” researchers wrote, “as they are highly prevalent, associated with poor functional outcomes, and resistant to pharmacologic treatment.”

The pilot study randomized 55 adults with schizophrenia or schizoaffective disorder with moderate-to-severe negative symptoms to 25 twice-weekly, hour-long group sessions of either CBSST-CCT or goal-focused supportive contact. Both interventions were delivered by master’s-level clinicians.

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Assessments demonstrated significant effects of CBSST-CCT on negative symptom severity as assessed by the Scale for the Assessment of Negative Symptoms, researchers reported. Improvements in diminished motivation drove improvements in negative symptoms.

Compared with participants in the supportive contact group, those who received CBSST-CCT had improved verbal learning and memory performance. According to durability analyses, effects were maintained through the 6-month follow-up assessment.

“It is important to note that the statistically significant improvements in the CBSST-CCT group were detectable even in the context of a small sample size and significant drop-out rates,” researchers wrote. “These findings add to our previous separate randomized controlled trials of CBSST and CCT in schizophrenia that have also demonstrated positive treatment effects on cognition, functioning, quality of life, and negative symptom severity (CBSST).”

Larger studies of CBSST-CCT are warranted, they added, to further examine the intervention’s efficacy, as well as mediators and moderators of treatment effects.

Reference

Granholm E, Twamley EW, Mahmood Z, et al. Integrated cognitive-behavioral social skills training and compensatory cognitive training for negative symptoms of psychosis: effects in a pilot randomized controlled trial. Schizophr Bull. Published online October 19, 2021. doi: 10.1093/schbul/sbab126