Treatment Response to Rehabilitation in Schizophrenia

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We propose a prospective study to investigate the relationship of symptoms and neurocognitive impairment to treatment response to a comprehensive rehabilitation program for patients with schizophrenia. Study 1 will investigate the relationship of symptoms and neurocognitive variables measured at program entry to psychosocial and vocational status measured two years later. Study 2 will investigate the relationship of symptoms and neurocognitive variables measured at program entry to treatment response for patients assigned to either a cognitive remediation track or a computer skills training track as part of their rehabilitation treatment. For Study 1 it is predicted that patients with neurocognitive impairment in problem-solving, verbal memory and/or visual vigilance measured at entry to a rehabilitation program will show poorer psychosocial and employment outcome measured one-year later, relative to patients without these impairments. For Study 2, it is predicted that neurocognitive impairment measured at entry to the rehabilitation program will be related to specific components of rehabilitation treatments. We hypothesize that: a. Those patients showing impairment in problem-solving, verbal memory and/or visual vigilance, will show greater improvement in psychosocial and employment status when treated with cognitive remediation relative to patients treated with computer skills training. b) Those patients showing little impairment in these aspects of neurocognition will show greater improvement in psychosocial and employment status when treated with computer skills training, relative to patients treated with cognitive remediation. The study will provide new information regarding: (1) relationships between neurocognition and symptoms to outcome after treatment, thereby identifying patient features that need to be addressed to improve treatment response; (2) relationships of neurocognition and symptoms to outcome after treatment with specific elements of an intensive rehabilitation treatment program, thereby providing an empirical basis for matching of patients to specific behavioral treatments.