Durable Cognitive Gains and Symptom Improvement Are Observed in Individuals with Recent-Onset Schizophrenia 6 Months after a Randomized Trial of Auditory Training Completed Remotely

Objective: Cognitive impairment in schizophrenia predicts functional outcomes and is largely unresponsive to pharmacology or psychotherapy; it is thus a critical unmet treatment need. This article presents the impact of remotely completed, intensive, targeted auditory training (AT) vs control condition computer games (CG) in a double-blind randomized trial in young adults with recent-onset schizophrenia. Method: Participants (N = 147) were assessed for cognition, symptoms, and functioning at baseline, post-intervention, and at 6-month follow-up. All participants were provided with laptop computers and were instructed to complete 40 hours remotely of training or computer games. An intent-To-Treat analysis (N = 145) was performed using linear mixed models with time modeled as a continuous variable. Planned contrasts tested the change from baseline to post-Training, baseline to 6-month follow-up, and post-Training to 6-month follow-up. Results: Global Cognition, which had improved in the AT group relative to the CG group at post-Training, showed durable gains at 6-month follow-up in an omnibus group-by-Time interaction test (F(1,179) = 4.80, P =. 030), as did Problem-Solving (F(1,179) = 5.13, P =. 025), and Speed of Processing improved at trend level significance (F(1,170) = 3.80, P =. 053). Furthermore, the AT group showed significantly greater improvement than the CG group in positive symptoms (F(1,179) = 4.06, P =. 045). Conclusions: These results provide the first evidence of durable cognitive gains and symptom improvement at follow-up of cognitive training (CT) in early schizophrenia completed independently and remotely. While functioning did not show significant improvement, these findings suggest that intensive targeted CT of auditory processing is a promising component of early intervention to promote recovery from psychosis.