Background and Hypothesis The number of clinical efficacy trials of Cognitive Remediation (CR), a behavioral intervention consisting of cognitive task practice and/or strategy training to improve cognitive skills in schizophrenia, has increased substantially over the past 25 years. While recent reviews have highlighted the effects of CR on cognition and function, CR effects on negative symptoms remain understudied. Given the overlap between negative symptoms and cognition, CR effects might be expected. Study Design Electronic databases were evaluated up to September 2023 using a broad range of search terms. Sixty-nine unique, controlled trials that used negative symptoms as an outcome were meta-analyzed. Data were independently extracted with excellent (>98%) reliability. Random effects models assessed the effects of CR on summary and expressive vs. experiential negative symptoms. Moderator analyses evaluated a broad array of treatment and participant factors. Study Results The meta-analysis (5319 participants) revealed that CR produced a small effect size improvement on summary negative symptoms (Hedge’s g = 0.179). Sample differences in age, duration of illness, symptoms, and antipsychotic dosage did not serve as a barrier to treatment benefit. CR also produced small-to-moderate improvements in alogia (Hedge’s g = 0.312) but not experiential negative symptoms. Programs of CR that utilized bridging activities that relate training of cognitive skills to activities of daily living produced greater improvement in negative symptoms (g = 0.281 vs 0.055). Longer CR programs also produce larger effects on negative symptoms. Conclusions CR produces small, consistent reductions in negative symptoms in people with schizophrenia. Variations in CR effects may be linked to different treatment ingredients.

中文翻译：

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认知矫正对精神分裂症谱系疾病阴性症状的影响：疗效的荟萃分析调查


背景和假设认知补救 （CR） 是一种行为干预，包括认知任务练习和/或策略训练，旨在提高精神分裂症的认知技能，其临床疗效试验的数量在过去 25 年中大幅增加。虽然最近的综述强调了 CR 对认知和功能的影响，但 CR 对阴性症状的影响仍未得到充分研究。鉴于阴性症状和认知之间的重叠，CR 效应可能是预期的。研究设计 使用广泛的检索词对截至 2023 年 9 月的电子数据库进行了评价。对 69 项使用阴性症状作为结局的独特对照试验进行了荟萃分析。数据独立提取，可靠性极高 （>98%）。随机效应模型评估了 CR 对总结和表达与体验性阴性症状的影响。主持人分析评估了广泛的治疗和受试者因素。研究结果 荟萃分析（5319 名参与者）显示，CR 对总阴性症状产生了小的效应量改善 （Hedge's g = 0.179）。年龄、病程、症状和抗精神病药物剂量的样本差异不会成为治疗获益的障碍。CR 还对失语症 （Hedge 的 g = 0.312） 产生了小到中度的改善，但没有出现体验性阴性症状。利用将认知技能训练与日常生活活动联系起来的桥接活动的 CR 计划对阴性症状产生了更大的改善 （g = 0.281 vs 0.055）。较长的 CR 计划对阴性症状的影响也更大。结论 CR 使精神分裂症患者的阴性症状略有、持续地减少。 CR 效果的变化可能与不同的治疗成分有关。