Does hedonic capacity moderate improvement during Cognitive Enhancement Therapy for early-course schizophrenia? Preliminary findings.

Poster B25, Tuesday, October 9, 11:30 am - 1:00 pm, Essex Ballroom

Raquelle Mesholam-Gately1,2, Gautami Shashidhar2, Ramya Ramadurai2, Shezal Padani2, Annaliese Lausberg3,4, Joanne Wojcik1,2, Luis Sandoval1,2, Rosa Johnson5, Jerred Endsley5, Shaun Eack3,4, Matcheri Keshavan1,2,4; 1Department of Psychiatry, Harvard Medical School, 2Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, 3School of Social Work, University of Pittsburgh, 4Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 5Massachusetts Mental Health Center

Cognitive Enhancement Therapy (CET) has shown substantial and lasting effects on neurocognition in schizophrenia. This ongoing study compares the effects and durability of CET to an Enriched Supportive Therapy (EST) control condition in early-course schizophrenia (ES). Prior pilot findings from this study suggested differential neurocognitive improvements favoring CET but have not yet examined the role of hedonic capacity (HC) on these effects. ES outpatients were randomized to CET or EST as part of a 2.5-year randomized-controlled trial. Neurocognition was assessed with the MATRICS Consensus Cognitive Battery (MCCB) and HC was evaluated with pleasantness ratings on the Modified Brief Smell Identification Test. Linear mixed-effects analyses were performed on data from 67 participants at baseline (41 CET, 26 EST) and 37 at 9 months (21 CET, 16 EST). Preliminary results confirmed previous findings of a significant time x group interaction favoring CET on the MCCB Composite score. Of note, there was a main effect for HC in both groups, indicating that those with the largest ranges of ratings between the most pleasant and unpleasant odors showed better neurocognitive performance in their respective conditions. These initial findings continue to suggest that CET is effective in ES, but that the extent of neurocognitive improvement may be partially moderated by HC. Considering the critical role of hedonic and other reward processes in learning, these findings have important implications for incorporating targeted reward-enhancing interventions in cognitive rehabilitation for people with ES. As data for this study accrues, the durability of these effects can be examined further.

Topic Area: Neurocognition

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