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.

Results (Indonesian) 1:

Diskusi Kami bertujuan untuk menemukan apakah komputer-dibantu kognitif remediasi (CACR) dapat memodifikasi kinerja kognitif pada dikirimkan penderita skizofrenia. Menggunakan program terdiri dari 20 sesi pelatihan 4 fungsi kognitif (perhatian / konsentrasi, memori kerja, fungsi eksekutif) dengan menggunakan perangkat lunak Rehacom ®, kami menemukan bahwa CACR bisa meningkatkan performa perhatian / kewaspadaan, memori kerja dan calon dan retrospektif memori. Secara keseluruhan, kinerja kognitif dan kapasitas fungsional peserta ditingkatkan. Semua pasien dibandingkan setelah mengikuti-up. Berdasarkan hasil penelitian ini, perhatian / kewaspadaan, memori kerja dan calon dan retrospektif memori diperbaiki pada semua pasien setelah mereka menerima CACR. Kami juga menemukan bahwa waktu reaksi meningkat dari posttest untuk menindaklanjuti 2. Itu adalah, pengobatan tidak memiliki efek apapun dalam jangka panjang. Nilai memori kerja berkurang dari baseline untuk tindak lanjut 1, tetapi meningkat dari 1to mengikuti mengikuti 2, yang berarti bahwa pengobatan memiliki efek positif dalam jangka panjang. Pada pasien dengan tanda-tanda positif, jumlah kelalaian meningkat dari posttest untuk menindaklanjuti 2, berarti bahwa pengobatan tidak memiliki efek apapun dalam jangka panjang. Pada pasien dengan tanda-tanda positif, PRMQ5 meningkat dari posttest untuk menindaklanjuti 2, berarti bahwa pengobatan tidak memiliki efek apapun dalam jangka panjang. Pada pasien dengan tanda-tanda positif, PRMQ16 diturunkan dari baseline menjadi posttest, yang berarti bahwa pengobatan memiliki efek positif dalam jangka panjang. Pada pasien dengan tanda-tanda positif, PRMQ16 meningkat dari posttest untuk menindaklanjuti 2, berarti bahwa pengobatan tidak memiliki efek apapun dalam jangka panjang. Kami mengamati tidak ada efek CACR gejala positif atau negatif. Namun, tindak lanjut periode itu jelas terlalu pendek untuk mengamati efek seperti yang mungkin memakan waktu yang relatif lama sebelum menjadi jelas. Dalam sebuah analisis eksplorasi, kami mengamati bahwa interaksi kumpulan × signifikan waktu hanya diamati untuk reaksi dalam tugas CPT (penghilangan) dan calon dan retrospektif memori (p = 16). Temuan penting dari studi ini adalah tidak adanya pengaruh yang signifikan dari CACR pada gejala positif dan negatif. Studi sebelumnya seperti yang dilakukan oleh Amato et al., (22) mengamati tidak ada perbaikan dalam gejala positif atau negatif yang diukur dengan positif dan negatif sindrom skala (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.