Discussion We aimed to find whether

Discussion
We aimed to find whether computer – assisted cognitive remediation (CACR) is able to modify cognitive performance in remitted patients with schizophrenia. Using a program consisting of 20 training sessions of 4 cognitive functions (attention / concentration, working memory, executive function) by means of the Rehacom® software, we found that CACR could improve performance in attention / vigilance, working memory and prospective and retrospective memory.
Overall, the cognitive performance and functional capacity of the participants were improved. All patients were compared after the follow – up. Based on the results of this study, attention / vigilance, working memory and prospective and retrospective memory were improved in all patients after they received CACR. We also found that the reaction time was increased from the posttest to the follow up 2. That is, the treatment did not have any effects in the long term. The working memory scores were reduced from the baseline to the follow up 1, but it was increased from the follow 1to the follow 2, meaning that the treatment had a positive effect in the long term. In patients with positive signs, the number of omissions was increased from the posttest to the follow up 2, meaning that the treatment did not have any effects in the long term. In patients with positive signs, the PRMQ5 was increased from the posttest to the follow up 2, meaning that the treatment did not have any effects in the long term. In patients with positive signs, the PRMQ16 was reduced from the baseline to the posttest, which means that the treatment had a positive effect in the long term. In patients with positive signs, the PRMQ16 was increased from the posttest to the follow up 2, meaning that the treatment did not have any effects in the long term. We observed no effect of CACR in the positive or negative symptoms. However, the follow up period was certainly too short to observe such effects which may take a relatively long time before becoming apparent .
In an exploratory analysis, we observed that a significant time × group interaction was only observed for reaction time in CPT task (omission) and prospective and retrospective memory (p = 16). An important finding of this study was the absence of a significant effect of CACR on positive and negative symptoms. Previous studies such as one conducted by Amato et al., (22) observed no improvement in positive or negative symptoms measured by Positive and Negative Syndrome Scale (PANSS).
In summary, the present study indicated an improvement in cognitive functioning. However, no differential effect was observed in different levels of differential improvement in patient relevant outcome measures. Thus, CACR was effective in improving the performances of schizophrenic patients in attention, working memory and prospective and retrospective memory. These findings corroborate with those of previous studies (35, 36, 37). There were several limitations in this study. First, the participants were not randomly assigned to CACR. Second, we did not find a clear effect of CACR on changing the symptoms as measured by the PANSS. Third, we only reported the results of one group comprising of 15 participants. The sample size of the previous studies was about 20 but due to difficulty reaching them, we selected 15 participants. In this study, unfortunately, patients received antipsychotic medication, and we could not compare the efficacy of antipsychotic medication on the patients’ functioning. Future studies are necessary to determine the effective framework for antipsychotic medication on patients’ functioning. Our encouraging finding will need to be replicated with a larger sample size. Even with these limitations, the results of this study indicate that CACR may be effective in clinical, neuropsychological and functional outcomes. More studies with longer follow-up periods are needed to generalize the results of this study and to verify the effects of this cognitive training program.