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Cognitive Remediation Therapy (CRT) in Adolescents With EOS

This study has been completed.
Instituto de Salud Carlos III
Centro de Investigación Biomédica en Red de Salud Mental
Information provided by (Responsible Party):
Olga Puig, Hospital Clinic of Barcelona Identifier:
First received: October 3, 2012
Last updated: July 6, 2013
Last verified: July 2013
Cognitive Remediation Therapy (CRT) can enhance cognitive performance in schizophrenia improving functional outcome. But most of the studies have involved participants who are in average in their mid 30s, and little is known about the efficacy of CRT in adolescents with early-onset schizophrenia (EOS). The aim of this study is to investigate efficacy of CRT in improving cognitive performance and functional outcome in adolescents with EOS. We expect to find that CRT improves cognitive and functional outcomes in adolescents with schizophrenia.

Condition Intervention
Behavioral: Cognitive Remediation Therapy

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Efficacy of a Cognitive Remediation Treatment in Adolescents With Schizophrenia Spectrum Disorders

Resource links provided by NLM:

Further study details as provided by Olga Puig, Hospital Clinic of Barcelona:

Primary Outcome Measures:
  • Cognitive performance [ Time Frame: 20 weeks ]
    Change from baseline in neuropsychological test scores of memory, executive functions, working memory and processing speed at post-treatment evaluation

Secondary Outcome Measures:
  • Functional outcome [ Time Frame: 20 weeks ]
    Change in real-world functioning scales, self-esteem and caregiver burden at post-treatment evaluation

  • Symptoms [ Time Frame: 20 weeks ]
    Change from baseline in measures of clinical symptoms at post-treatment evaluation

Enrollment: 50
Study Start Date: January 2007
Study Completion Date: December 2012
Primary Completion Date: December 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Cognitive Remediation Therapy
CRT: Frontal/Executive Program. The program has a duration of 40 sessions, with two session for week. Is is carried out individually and utilizes paper and pencil tasks. The main technique utilized is the scaffolding in a context of learning without errors.
Behavioral: Cognitive Remediation Therapy
Other Names:
  • Cognitive training
  • Cognitive enhancement

Detailed Description:

Early-onset schizophrenia (EOS) is associated with worse course and poor outcome than adulthood schizophrenia. Cognitive deficits are known to be a core feature in EOS, with large deficits on almost all cognitive domains. Importantly, cognitive deficits are known to be strong predictors of psychosocial and functional outcomes in schizophrenia and also in the early-onset form of the illness. Cognitive Remediation Therapy (CRT) is a behavioral training based intervention that aims to improve cognitive processes (attention, memory, executive function, social cognition or metacognition) with the goal of durability and generalization. It has been demonstrated that CRT improve cognitive deficits and functional outcome in adult patients but there are very few studies with adolescent samples.

A controlled randomized study will be carry out with two groups: patients receiving treatment as usual plus CRT, and patients receiving treatment as usual (TAU). The independent variable is the cognitive remediation treatment. The CRT will be applied according to the manual of Wykes and Reeder (2005). The program has a duration of 40 sessions, with two session for week. It is carried out individually and utilizes paper and pencil tasks. The main technique utilized is the scaffolding in a context of learning without errors.

The main dependent variable is the cognitive performance measured through neuropsychological tests. Other secondary dependent variables are functional outcome and clinical symptoms obtained from the psychometric evaluation.

All participants will be evaluated before and after the experimental intervention in several neurocognitive domains, clinical symptoms and functional outcome. The evaluations will be carried out by expert evaluators. Intention-to-treat analysis will be carry out using the statistical package SPSS v 18.


Ages Eligible for Study:   12 Years to 18 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • age between 12 and 18 years
  • a DSM-IV-TR schizophrenia-type disorder (schizophrenia or schizoaffective disorder), with onset before the age of 17
  • being clinically and pharmacologically stabilized during the last 6 weeks before the baseline assessment
  • the estimation of not modifying pharmacological antipsychotic treatment
  • presence of cognitive deficit confirmed by the neuropsychological battery

Exclusion Criteria:

  • IQ below 70
  • presence of an active misuse disorder
  • presence of organic brain syndromes or neurological disorders
  • having received electroconvulsive therapy in the previous 6 months
  Contacts and Locations
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Please refer to this study by its identifier: NCT01701609

Department of Child and Adolescent Pyshicatry and Psychology
Barcelona, Catalunya, Spain, 08036
Sponsors and Collaborators
Hospital Clinic of Barcelona
Instituto de Salud Carlos III
Centro de Investigación Biomédica en Red de Salud Mental
Principal Investigator: Olga Puig, PhD Hospital Clinic of Barcelona
Study Director: Rafael Penadés, PhD Hospital Clínic de Barcelona
Study Director: Josefina Castro-Fornieles, MD Hospital Clínic de Barcelona
  More Information

Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Olga Puig, Olga Puig Navarro, Hospital Clinic of Barcelona Identifier: NCT01701609     History of Changes
Other Study ID Numbers: PI07/90054
ETES07/90054 ( Other Grant/Funding Number: ISCIII )
Study First Received: October 3, 2012
Last Updated: July 6, 2013

Keywords provided by Olga Puig, Hospital Clinic of Barcelona:
early-onset schizophrenia
cognitive remediation therapy

Additional relevant MeSH terms:
Schizophrenia Spectrum and Other Psychotic Disorders
Mental Disorders processed this record on May 25, 2017