Tunisian Adolescents at CHR for Psychosis: A Pilot Study of Cognitive Remediation in a LMIC.

Journal: Early intervention in psychiatry

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Affiliated Institutions:  Child and Adolescent Psychiatric Department, Razi University Hospital, Tunis, Tunisia. Faculty of Medicine of Tunis, El-Manar Tunis University, Tunis, Tunisia. UCLA Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA.

Abstract summary 

Clinical high risk (CHR) youth are known to exhibit cognitive deficits at similar levels to their more severally ill counter parts. Cognitive training (CT) programs offer a promising method for early intervention and the prevention of further cognitive decline in this vulnerable population. However, there are few structured CT intervention programs addressing the needs of CHR youth in LMICs of the Middle East.We conducted a study in the Child and Adolescent Psychiatry Department of Razi University Hospital. Patients were assessed by trained raters with the "Comprehensive Assessment of At-Risk Mental States" to confirm their CHR status. Cognitive Training (CT) was combined with the Neuropsychological Educational Approach to Remediation (CT-NEAR) as part of a social rehabilitation program. We enrolled 25 CHR patients and examined several domains of cognitive functioning and evaluated daily functioning prior to starting the intervention and after completion.There were 20 patients who completed the study. The CT-NEAR group (n = 10) completed an average number 28.33 sessions over 12 weeks, which were matched for therapist time with the TAU group (n = 10). We found statistically significant improvements in CT-NEAR versus TAU in several cognitive domains; such as cognitive flexibility, memory-short and long-term, and verbal fluency. Also, CT-NEAR versus TAU patients improved in global functioning.Our findings indicate that cognitive remediation versus TAU for Tunisian CHR youth is feasible and effective especially in improving cognitive functioning when delivered in a social rehabilitation context (Bridging Group) and extends to global level of functioning.

Authors & Co-authors:  Abbes Zeineb Z Taleb Sana S Yahia Houda Ben HB Hmidi Hajer H Hajri Melek M Jelili Selima S Halayem Soumeya S Mrabet Ali A Ventura Joseph J Bouden Asma A

Study Outcome 

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Statistics
Citations :  Andreou, C., S. Eickhoff, M. Heide, R. de Bock, J. Obleser, and S. Borgwardt. 2023. “Predictors of Transition in Patients With Clinical High Risk for Psychosis: An Umbrella Review.” Translational Psychiatry 13, no. 1: 286.
Authors :  10
Identifiers
Doi : 10.1111/eip.13614
SSN : 1751-7893
Study Population
Male,Female
Mesh Terms
Other Terms
Bridging Groups;LMIC;MENA;Tunisia;adolescents;clinical high risk;cognitive remediation;global functioning
Study Design
Study Approach
Country of Study
Tunisia
Publication Country
Australia