Effectiveness of Integrated NeurocognitiveTherapy on Cognitive Impairment and Functional Outcome forSchizophrenia Outpatients

Cognitive impairment is highly prevalent in patients with schizophrenia and schizoaffective disorder. Many interventions havebeen developed to treat cognitive deficit, since it has a strong impact on functional outcome; however, there are no integratedinterventions targeting multiple neuro- and social-cognitive domains with a particular focus on the generalization of the effects oftherapy on the functional outcome. Recently, a group of experts has developed a cognitive remediation group therapy approachcalled Integrated Neurocognitive Therapy (INT), which includes exercises to improve the MATRICS (Measurement and TreatmentResearch to Improve Cognition in Schizophrenia) neuro- and social-cognitive domains. This systematic review and meta-analysisaimed to assess the efficacy of this approach. We conducted a search of PubMed, Scopus, Web of Science, and PsycINFO to selectprimary studies evaluating INT in schizophrenic and schizoaffective patients. The primary outcomes of the meta-analysis includednegative and positive symptoms and global functioning. Two randomized controlled trials met inclusion criteria. A total of 217participants were included. Based on the results from the Positive and Negative Syndrome Scale (PANSS), a significant pooledeffect size was observed for negative symptoms, which demonstrated not only an improvement in the patients treated immediatelyafter therapy but also a permanence of positive results at a 9–12-month follow-up. On the other hand, no significant effect size wasobserved for positive symptoms. In addition, a significant pooled effect size was found for Global Assessment of Functioning (GAF),which shows how INT’s integrated approach has lasting positive implications on patients’ functional outcome. We concluded thatINT might be an effective treatment for negative symptoms and global functioning in patients with schizophrenia, compared totreatment as usual (TAU).