COMBINING PHARMACOTHERAPY AND COGNITIVE TRAINING IN SCHIZOPHRENIA: EFFECTS ON COGNITION AND FUNCTIONAL OUTCOME

Abstract Objectives Cognitive impairment is a common feature of psychiatric disorders. The Screen for Cognitive Impairment in Psychiatry (SCIP) has been developed for routine screening of psychiatric patients and is available in several languages. The German version (SCIP-G) was used in 3 studies: 1. to investigate the feasibility, reliability and validity of the SCIP-G [Sachs et al. Schizophr. Res. Cogn. 2021: 25, 100197], 2. to perform a confirmatory factor analysis [Sachs et al. Schizophr. Res. Cogn. 2022: 29, 100259], and 3. to assess patients before and after standard inpatient treatment including cognitive training. Methods Study 1 included patients with schizophrenia or schizoaffective psychosis and thirty healthy controls matched for sex, age and education. In study 3, all patients received modern pharmacotherapy plus cognitive remediation using the COGPACK® software package version 6.06; 54 patients were diagnosed with F2 (schizophrenia, schizotypal and delusional disorder) based on ICD-10 research criteria. They were compared with 39 patients meeting criteria for bipolar disorder (F30 and F31) and 50 for depression (F32 and F33). Results In Study 1, significant differences in cognitive performance were found between patients and healthy controls on both versions of the SCIP. The SCIP discriminated effectively between patients and controls. In Study 2, a two-factor solution yielded a good model fit (χ² = 6.7, df = 3, p =.08, χ²/df = 2.2). In study 3, the total SCIP score showed significant improvement after treatment in all three diagnostic groups (p<.001), with no statistically significant interaction between total SCIP score and diagnostic group (p =.860). Conclusion Our data suggest that the SCIP-G is a valid and reliable instrument for the assessment of cognitive impairment. Good model fit can be achieved with a two-factor solution for the SCIP. Inpatient treatment consisting of pharmacotherapy and cognitive training improved cognitive deficits. This improvement in cognitive performance was observed to a similar extent in patients with schizophrenia, bipolar disorder and major depression and were accompanied by improvements in functional outcome.