Evidence map›Paper›PMID 38428943›Full record

Trial reportSchizophrenia bulletin2024

Understanding the Mechanisms of Cognitive Remediation on Recovery in People With Early Psychosis: A Mediation and Moderation Analysis.

Rose Tinch-Taylor, Andrew Pickles, Dominic Stringer, Emese Csipke, Matteo Cella, Paul McCrone, Clare Reeder, Max Birchwood, David Fowler, Kathryn Greenwood and 10 more

Open access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Schizophrenia bulletin, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
4.2field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 11 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 9 institutions in 2 countries.

Rose Tinch-TaylorInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Andrew PicklesInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Dominic StringerInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Emese CsipkeInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Matteo CellaInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Paul McCroneSchool of Health Sciences, University of Greenwich, London, UK.
Clare ReederInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Max BirchwoodWarwick Medical School, University of Warwick, Coventry, UK.
David FowlerSchool of Psychology, University of Sussex, Brighton, UK.
Kathryn GreenwoodSchool of Psychology, University of Sussex, Brighton, UK.
Sonia JohnsonFaculty of Brain Sciences, University College London, London, UK.
Jesus PerezCambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.
Rosa RitunnanoWarwick Medical School, University of Warwick, Coventry, UK.
Andrew ThompsonWarwick Medical School, University of Warwick, Coventry, UK.
Rachel UpthegroveSchool of Psychology, University of Birmingham, Birmingham, UK.
Jon WilsonNorfolk and Suffolk NHS Foundation Trust, Norwich, UK.
Alex KennyPatient Advisory Board, King's College London, London, UK.
Iris IsokPatient Advisory Board, King's College London, London, UK.
Eileen M JoyceUCL Queen Square Institute of Neurology, University College London, London, UK.
Til WykesInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.ORCID 0000-0002-5881-8003
King's College London · GBUniversity of Warwick · GBUniversity of Sussex · GBCambridgeshire and Peterborough NHS Foundation Trust · GBNorfolk and Suffolk NHS Foundation Trust · GBQueen Mary University of London · GBUniversity College Birmingham · GBUniversity College London · GBUniversity of Greenwich · GB

Funding

National Institute for Health Research RP-PG-0612-20002
6 · The paper itself

Abstract

backgroundTo provide precision cognitive remediation therapy (CR) for schizophrenia, we need to understand whether the mechanism for improved functioning is via cognition improvements. This mechanism has not been rigorously tested for potential moderator effects. STUDY

designWe used data (n = 377) from a randomized controlled trial using CIRCuiTS, a therapist-supported CR, with participants from first-episode psychosis services. We applied structured equation modeling to test whether: (1) CR hours explain the goal attainment functional outcome (GAS) at posttreatment, (2) global cognitive improvement mediates GAS, and if (3) total symptoms moderate the CR hours to cognitive improvement pathway, and/or negative symptoms moderate the cognition to functioning pathway, testing moderator effects via the mediator or directly on CR hours to functioning path. STUDY

resultsCR produced significant functioning benefit for each therapy hour (Coeff = 0.203, 95% CI 0.101-0.304, P < .001). The mediated path from CR hours to cognition and cognition to functioning was small and nonsignificant (Coeff = 0.014, 95% CI = -0.010, 0.037, P = .256). Total symptoms did not moderate the path to cognition (P = .211) or the direct path to outcome (P = .896). However, negative symptoms significantly moderated the effect of cognitive improvements on functioning (P = .015) with high negative symptoms reducing the functional gains of improved cognition.

conclusionsAlthough cognitive improvements were correlated with functioning benefit, they did not fully explain the positive effect of increased therapy hours on functioning, suggesting additional CR factors also contribute to therapy benefit. Negative symptoms interfere with the translation of cognitive improvements into functional gains so need consideration.

Indexed as

Cognitive RemediationOutcome Assessment, Health CarePsychotic DisordersSchizophreniaAdolescentAdultCognitive DysfunctionFemaleHumansMaleMediation AnalysisYoung Adultcognitivemechanismsmediationpsychosisrecoveryremediation

Identifiers

PMID38428943
PMCPMC11548933
OpenAlexW4392344587

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.