A Randomized Clinical Trial of Group Cognitive-Rehabilitation Therapy for Patients with Schizophrenia Resistant to Medication

Objectives: Against the background of evidence-based treatments for schizophrenia resistant to medication, the implementation of cognitive-Rehabilitation therapy (CRT) becomes more important, especially about patients who don’t response to medication. There is less evidence for group format and face to face structure of CRT and also for resistant to medication patients. This research investigates the efficacy of GCRT decreasing positive and negative symptoms of schizophrenia and improving cognitive function.  Methods: A Randomized Controlled Trial was used to compare the efficacy of GCRT that of patients who receive treatment as usual (TAU). From Razi hospital in Tehran, 40 inpatient people with schizophrenia resistant to medication and persistent negative and positive symptoms were assigned. Patients were included if they were aged 25 to 55 years had diagnosis of schizophrenia for at least 2 years and were persistent to medication for 2 years. 20 of them received a 16 session’s treatment over 2 months and 20other ones were in waiting list. All Patients received TAU throughout the study. In all, 40 completed treatment. The positive and negative symptoms scales, NOSIE & NCSE completed for all patients before, in the middle and after treatment. Results: Spss 11.5 and multivariate repeated measure was used. There were significant differences between the GCBT and TAU on positive and negative symptoms of schizophrenia. Significant improvement were found in the severity and number of positive (P=0.05) and negative (P=0.001) symptoms in patients treated with GCRT. GCRT leaded to improvement in cognitive functions (P=0.001) but there was no change in behavioral functions. In control group there were no significant differences between three measures (pre, middle and post). Discussion: GCRT is a useful adjunct therapy in the management of patients with schizophrenia resistant to medication in treating negative & positive symptoms as well as cognitive deficits.