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Compensatory Interventions for Cognitive Impairments in Psychosis: A Systematic Review and Meta-Analysis

Abstract

Objective

Cognitive compensatory interventions aim to alleviate psychosocial disability by targeting functioning directly using aids and strategies, thereby minimizing the impact of cognitive impairment. The aim was to conduct a systematic review and meta-analysis of cognitive compensatory interventions for psychosis by examining the effects on functioning and symptoms, and exploring whether intervention factors, study design, and age influenced effect sizes.

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Twenty-six studies, from 25 independent randomized controlled trials (RCTs) were included in the meta-analysis [1654 participants, mean age = 38.9 years] Meta-analysis revealed a medium effect of compensatory interventions on functioning compared to control conditions… with evidence of relative durability at follow-up.

Analysis also revealed small significant effects of cognitive compensatory treatment on negative, positive, and general psychiatric symptoms, but not depressive symptoms. Longer treatment length was associated with larger effect sizes for functioning outcomes.

Conclusion: Cognitive compensatory interventions are associated with robust, durable improvements in functioning in people with psychotic illnesses.