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Cognitive Training for Schizophrenia in Developing Countries: A Pilot Trial in Brazil

DOI: 10.1155/2013/321725

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Cognitive deficits in schizophrenia can massively impact functionality and quality of life, furthering the importance of cognitive training. Despite the development of the field in Europe and in the United States, no programmes have been developed and tested in developing countries. Different cultural backgrounds, budget restrictions, and other difficulties may render treatment packages created in high income countries difficult for adoption by developing nations. We performed a pilot double-blind, randomized, controlled trial in order to investigate the efficacy and feasibility of an attention and memory training programme specially created in a developing nation. The intervention used simple, widely available materials, required minimal infrastructure, and was conducted in groups. The sample included seventeen stable Brazilians with schizophrenia. Sessions were conducted weekly during five months. The cognitive training group showed significant improvements in inhibitory control and set-shifting over time. Both groups showed improvements in symptoms, processing speed, selective attention, executive function, and long-term visual memory. Improvements were found in the control group in long-term verbal memory and concentration. Our findings reinforce the idea that cognitive training in schizophrenia can be constructed using simple resources and infrastructure, facilitating its adoption by developing countries, and it may improve cognition. 1. Introduction Impaired cognitive functioning in schizophrenia was early recognized [1, 2] and described as one of the core symptoms [3]. Deficits may be present since the first manifestations of the disease or may appear before the onset of symptoms [4]. Up to 80% of all people with schizophrenia may present significant deficits [5]. Main deficits involve attention, memory, and executive functions, but other domains can also be affected, such as visuospatial ability, language, learning, and motor coordination [3, 6, 7]. Cognitive deficits have been related to impairment in functional abilities [8–10], compromising the ability to lead an independent life, to benefit from psychosocial treatments, to create and maintain social relationships, to find and keep a job, and to maintain academic development [6, 11–13]. Improvements in cognitive functions can increase benefits from other psychosocial rehabilitation programmes [14]; therefore, treatment of schizophrenia could also include cognitive training. A large number of outpatient consultations and re-hospitalization rates [15], difficulty in maintaining a job [6], and

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