~260 spots leftby Aug 2029

Cognitive Health Interventions for Schizophrenia

(iCogCA Trial)

Recruiting in Palo Alto (17 mi)
+4 other locations
Martin Lepage - The Douglas Research Centre
Overseen byMartin Lepage, PhD
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Douglas Mental Health University Institute
Disqualifiers: Intellectual disability, Hospitalization, High suicide risk, others
No Placebo Group

Trial Summary

What is the purpose of this trial?

The goal of this clinical trial is to effectively implement virtually-delivered interventions in mental health institutions nationwide to improve the cognitive health of individuals living with schizophrenia. The main objectives are: * To determine the clinical effectiveness of two virtual cognitive health interventions (i.e., Action-Based Cognitive Remediation or MetaCognitive Training). * To evaluate our implementation strategy involving the virtual delivery of cognitive health interventions combined with a digital learning platform to train mental health practitioners. Participants will be assessed for the severity of symptoms, cognitive performance, and overall functioning before and after receiving the intervention. Qualitative interviews will also be conducted with participants and therapists to evaluate the implementation strategies.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the treatment Cognitive remediation, Cognitive Remediation Therapy, Cognitive Training, Cognitive Rehabilitation, MetaCognitive Training, MetaCognitive Training, MCT for schizophrenia?

Research shows that cognitive remediation and metacognitive training can help improve thinking skills and social functioning in people with schizophrenia. These treatments have been found to reduce cognitive deficits and improve real-world outcomes, making them promising strategies for early intervention in schizophrenia.12345

Is metacognitive training (MCT) safe for people with schizophrenia?

The studies on metacognitive training (MCT) for schizophrenia do not report any safety concerns, suggesting it is generally safe for use in humans.34678

How is the treatment Cognitive Health Interventions for Schizophrenia different from other treatments for this condition?

Cognitive Health Interventions for Schizophrenia, including Cognitive Remediation and MetaCognitive Training, are unique because they focus on improving cognitive and social functioning through psychological therapy rather than medication. These treatments use computer-based exercises and group training to enhance thinking skills and correct cognitive biases, aiming to improve daily living and reduce symptoms like delusions.2391011

Research Team

Martin Lepage - The Douglas Research Centre

Martin Lepage, PhD

Principal Investigator

Douglas Mental Health University Institute

Eligibility Criteria

This trial is for individuals with schizophrenia or related disorders who are stable and can use online platforms. They must have a private space for sessions, an emergency contact, and be able to communicate in English or French. Those with intellectual disabilities, high suicide risk, or current hospitalization cannot join.

Inclusion Criteria

Participants must be able to nominate an emergency contact and to agree to allow researchers to contact their clinician and/or emergency services in the event of an emergency during study procedures
I can use online platforms and join groups as my doctor agrees.
Follow-up and treatment by a clinician at one of the services mentioned above
See 2 more

Exclusion Criteria

Hospitalization at the time of recruitment
I cannot speak or read English or French.
Intellectual disability
See 1 more

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive virtual cognitive health interventions (Action-Based Cognitive Remediation or MetaCognitive Training) over a period of 8-12 weeks

8-12 weeks
12 sessions (virtual)

Follow-up

Participants are monitored for safety and effectiveness after treatment, with assessments of symptomatology, cognitive performance, and overall functioning

4 weeks

Treatment Details

Interventions

  • Cognitive remediation (Behavioral Intervention)
  • MetaCognitive Training (Behavioral Intervention)
Trial OverviewThe study tests two virtual cognitive health interventions: Action-Based Cognitive Remediation and MetaCognitive Training. It aims to see if these can improve cognition in schizophrenia when delivered online alongside training mental health practitioners using digital platforms.
Participant Groups
2Treatment groups
Experimental Treatment
Group I: MetaCognitive TrainingExperimental Treatment1 Intervention
MCT, developed by Drs. Moritz (co-applicant) and Woodward (PI), is based in the theoretical foundations of CBT, but targets the biases underlying symptoms rather than symptoms directly. MCT includes eight modules targeting common cognitive errors and reasoning biases in schizophrenia that have, through decades of research, been shown to contribute to delusions (e.g., jumping to conclusions). MCT will be offered to groups of up to 8 participants over 12 sessions of 45-60 min each (two per week) through Zoom Health. Session aims include raising participants' awareness of distortions and prompting them to critically reflect on, expand upon, and change their current repertoire of problem-solving strategies.
Group II: Cognitive remediationExperimental Treatment1 Intervention
CR was developed by Dr. Bowie (PI). Approximately 60% of CR sessions are spent on cognitive training activities, 20% on developing, monitoring, and flexibly adjusting problem-solving strategies, and 20% on transfer activities. Transfer includes discussing and role-playing how cognitive skills and strategies are applied in everyday life and teaches potential compensatory strategies for overcoming cognitive challenges. Targeted cognitive domains are processing speed, attention, memory, and executive functions, which are all commonly impaired in psychosis. The manual includes 1.5-hour sessions and uses Brain Training Pro and will be offered over an 8-week period. Zoom Health will be used for group transfer activities.

Cognitive remediation is already approved in Canada for the following indications:

🇨🇦
Approved in Canada as Cognitive Training for:
  • Schizophrenia
  • Cognitive Impairment

Find a Clinic Near You

Who Is Running the Clinical Trial?

Douglas Mental Health University Institute

Lead Sponsor

Trials
31
Recruited
2,800+

Canadian Institutes of Health Research (CIHR)

Collaborator

Trials
1,417
Recruited
26,550,000+

Dr. Paul C. Hébert

Canadian Institutes of Health Research (CIHR)

Chief Executive Officer

MD, University of Ottawa

Dr. Paul C. Hébert

Canadian Institutes of Health Research (CIHR)

Chief Medical Officer

MD, University of Ottawa

McGill University

Collaborator

Trials
421
Recruited
1,017,000+
Philippe Drouet profile image

Philippe Drouet

McGill University

Chief Executive Officer since 2021

Master of Science and Bachelor in Chemical Engineering from McGill University

Marianne Mancini profile image

Marianne Mancini

McGill University

Chief Medical Officer

BS in Nutritional Sciences from McGill University

Findings from Research

Cognitive remediation strategies for schizophrenia have shown improvements in working memory, emotion perception, and executive function, indicating that targeted cognitive exercises can effectively engage underfunctioning brain systems.
Cognitive adaptation interventions have been linked to better symptoms, psychosocial status, and reduced relapse rates, suggesting that modifying the environment can help patients manage their cognitive deficits.
Neurocognitive rehabilitation for schizophrenia.Kurtz, MM.[2019]
Cognitive remediation has been shown to effectively reduce cognitive deficits and improve functional outcomes in individuals with schizophrenia, based on a review of various intervention programs and meta-analyses.
This approach is particularly beneficial when applied early in the course of schizophrenia and even in individuals at risk for developing the disorder, highlighting its potential as a key strategy for early intervention.
Cognitive remediation in schizophrenia: current status and future perspectives.Barlati, S., Deste, G., De Peri, L., et al.[2021]
In a study involving 50 outpatients with schizophrenia, metacognitive training (MCT) showed significant improvements in positive symptoms compared to treatment as usual (TAU).
While MCT was effective in reducing positive symptoms, it did not demonstrate superiority in improving cognitive biases or cognitive insight, indicating its targeted efficacy.
Efficacy of Metacognitive Training in a Chilean Sample of People with Schizophrenia.Acuña, V., Otto, A., Cavieres, A., et al.[2022]

References

Neurocognitive rehabilitation for schizophrenia. [2019]
Cognitive remediation in schizophrenia: current status and future perspectives. [2021]
Efficacy of Metacognitive Training in a Chilean Sample of People with Schizophrenia. [2021]
Efficacy of Metacognitive Training in a Chilean Sample of People with Schizophrenia. [2022]
Cognitive remediation: a promising tool for the treatment of schizophrenia. [2018]
Further evidence for the efficacy of a metacognitive group training in schizophrenia. [2022]
A Randomized Control Trial of Cognitive Compensatory Training (CCT) and Computerized Interactive Remediation of Cognition-Training for Schizophrenia (CIRCuiTS). [2023]
Efficacy of Metacognitive Training for Patients With Schizophrenia in Psychiatric Emergency Wards: A Pilot Randomized Controlled Trial. [2022]
A new generation computerised metacognitive cognitive remediation programme for schizophrenia (CIRCuiTS): a randomised controlled trial. [2022]
Cognitive training in schizophrenia: a neuroscience-based approach. [2021]
A review of cognitive remediation approaches for schizophrenia: from top-down to bottom-up, brain training to psychotherapy. [2019]