Analysis of the effectiveness of cognitive rehabilitation for patients with chronic mental illness: A meta-analysis

Table 1 Characteristics of included study

No.	Ref.	Intervention	Evaluation		Experimental group			Control group
					Pre (mean ± SD)	Post (mean ± SD)	Subjects (W/M)	Pre (mean ± SD)	Post (mean ± SD)	Subjects (W/M)
1	Song et al[25]	Rehacom	CNT	Memory	31.8 ± 6.2	36.4 ± 5.8	4/6	30.3 ± 5.1	31.2 ± 5.3	4/6
				Attention	36.9 ± 7.6	50.9 ± 32.8		41.3 ± 9.8	60.5 ± 36.1
2	Kim and Kim et al[24]	Visuospatial Rehabilitation	RCFT	Memory	11.5 ± 5.7	14.6 ± 6.1	8/6	12.3 ± 9.9	12.3 ± 9.9	8/7
			Stroop	Executive Function	33 ± 6.5	37.4 ± 7.1		34.7 ± 10.3	34.5 ± 12.7
			WCST	Attention	44.1 ± 30.7	33.2 ± 23.9		9.5 ± 4.4	11.3 ± 4.3
3	Pijnenborg et al[28]	REFLEX/CRT	QUID-Sr	Depression	4.1 ± 1.7	3.7 ± 1.9	59	3.8 ± 1.8	3.7 ± 1.9	62
			MANSA	Quality of life	58.179.2	58.8 ± 9.3		58.1 ± 9.9	56.9 ± 10.7
4	Iwata et al[22]	CogPack	BACSJ	Memory	0.2 ± 0.8	0.6 ± 0.8	22/7	-0.2 ± 1.1	0.1 ± 1.1	23/8
				Attention	0.1 ± 1	0.5 ± 1		-0.1 ± 1	0.1 ± 1.1
				Execution function	0.1 ± 1.1	0.3 ± 0.7		-0.1 ± 0.9	-0.1 ± 0.9
			LASMI	Social skill	14.1 ± 5.5	9.7 ± 5.4		14.5 ± 7.4	14.3 ± 7.5
5	Kim[26]	Group art therapy	ATQ-N	Depression	14 ± 5.3	11.7 ± 5.4	3/5	15.1 ± 4.9	15.6 ± 5.6	3/5
6	Salomonsson et al[29]	CBT	MADRS-S	Depression	15.6 ± 6.7	13.6 ± 8.3	58/23	14.6 ± 7.2	10.6 ± 7.3	51/29
7	Jung and Oh[23]	Group art therapy	BES	Memory	22.8 ± 2.5	24.6 ± 2.9	8/4	23.2 ± 2.9	22.4 ± 1.9	5/7
				Attention
				Executive Function
8	Twamley et al[30]	CCT	SSPA	Social Skills	4.1 ± 0.63	3.9 ± 0.11	34/43	4.2 ± 0.7	4 ± 0.1	32/44
			QOLI	Quality of life	4 ± 1.5	4.8 ± 0.2		4.1 ± 1.38	3.8 ± 0.2
			Ham-D	Depression	12.9 ± 6.9	10.4 ± 1.2		13 ± 6.8	14.9 ± 1.3
9	Lee et al[33]	Cognitive behavioral social skills Training	WHOQOL-BREF	Quality of life	6 ± 1.2	7.6 ± 1.2	5/3	6.7 ± 2.2	6 ± 2	7/5
10	Kim and Cho[27]	CBT	MHCS	Depression	3 ± 0.51	3.5 ± 0.6	6/7	3.2 ± 0.5	3.2 ± 0.7	5/8
			RCS	Social skill	2.9 ± 0.6	3.4 ± 0.6		3 ± 0.7	3.1 ± 0.7
11	Kingston et al[32]	Reasoning and Rehabilitation 2	CSS-M	Social skill	36.4 ± 11.6	29.7 ± 14.1	48	35.6 ± 14.6	35.9 ± 15.2	49
12	Hyun[31]	Cognitive Behavioral Group Therapy	Social skills scale	Social skills	39.1 ± 10.2	37.5 ± 9.6	13/13	39.7 ± 9.4	39.3 ± 9	15/11

CNT: Computer assisted cognitive rehabilitation; RCFT: Rey-osterrieth complex figure test; WCST: Wisconsin card sorting test; QUID-Sr: The Quick Inventory of Depressive Symptomatology Self-Report; MANSA: The self-rating Manchester Short Assessment of Quality of Life; BACSJ: Brief assessment of cognition in schizophrenia-Japane; LASMI: Life Assessment Scale for Mentally; ATQ-N: Automatic Thoughts Questionnaire-Negative; MADRS-S: Montgomery-Asberg Depression Rating Scale; BES: Basic Empathy Scale; CCT: Compensatory cognitive training; SSPA: Social Skills Performance Assessmen; QOLI: Quality of life interview; HAM-D: Hamilton depression rating scale; WHOQOL-BREF: World Health Organization Quality of Lif-BREF; CBT: Cognitive-behavior therapy; MHCS: Mental health confidence scale; RCS: Relationship change scale; CSS-M: The criminal sentiments scale-modified.

Table 2 Effect size of attention

Study	Diagnosis	Intervention	Effect size	95%CI	Weight (%)
Iwata et al[22]	Schizophrenia	CR using computer software	0.66	0.14-1.18	46.2
Jung and Oh[23]	Schizophrenia	CB group art therapy program	0.89	0.04-1.74	17.5
Kim and Kim[24]	Schizophrenia	Visuospatial rehabilitation	0.71	-0.04-1.47	22.0
Song et al[25]	Schizophrenia	CCP (RehaCom)	0.92	-0.01-1.85	14.4
Total			0.75	0.39-1.10	100

CR: Cognitive rehabilitation; CB: Cognitive behavior; CCP: Computerized cognition program.

Table 3 Effect size of memory

Study	Diagnosis	Intervention	Effect size	95%CI	Weight (%)
Iwata et al[22]	Schizophrenia	CR using computer software	1.26	0.70-1.82	42.6
Jung and Oh[23]	Schizophrenia	CB group art therapy program	0.68	-0.15-1.51	19.4
Kim and Kim[24]	Schizophrenia	Visuospatial rehabilitation	0.47	-0.27-1.21	24.2
Song et al[25]	Schizophrenia	CCP (RehaCom)	1.26	0.28-2.24	13.8
Total			0.96	0.59-1.32	100

CR: Cognitive rehabilitation; CB: Cognitive behavior; CCP: Computerized cognition program.

Table 4 Effect size of executive function

Study	Diagnosis	Intervention	Effect size	95%CI	Weight (%)
Iwata et al[22]	Schizophrenia	CR using computer software	0.22	0.09-0.35	71.2
Jung and Oh[23]	Schizophrenia	CB group art theraly program	0.28	-0.04-0.60	11.8
Kim and Kim[24]	Schizophrenia	Visuospatial rehabilitation	0.60	0.33-0.87	17.0
Total			0.29	0.18-0.40	100

CR: Cognitive rehabilitation; CB: Cognitive behavior.

Table 5 Effect size of depression

Study	Diagnosis	Intervention	Effect size	95%CI	Weight (%)
Kim[26]	Schizophrenia	CB group art therapy program	0.42	-0.04-0.89	0.4
Kim and Cho [27]	Schizophrenia	CB Program	0.38	0.09-0.68	1.0
Pijnenborg et al[28]	Psychosis	Social Cognitive Group Treatment	0.18	0.12-0.24	22.5
Salomonsson et al[29]	Mental Disorders	CB Therapy	0.29	0.24-0.33	40.3
Twamley et al[30]	Mental Illnesses	Compensatory CT	0.10	0.05-0.16	35.7
Total			0.20	0.17-0.23	100

CB: Cognitive behavior, CT: Cognitive training.

Table 6 Effect size of social skill

Study	Diagnosis	Intervention	Effect size	95%CI	Weight (%)
Hyun[31]	Schizophrenia	CB group therapy	0.41	-0.14-0.96	17.2
Iwata et al[22]	Schizophrenia	CR using computer coftware	3.01	2.25-3.76	9.2
Kim and Cho[27]	Schizophrenia	CB Program	1.91	0.95-2.86	5.7
Kingston et al[32]	Mental Illnesses	Cognitive skills program	2.48	1.95-3.02	18.2
Twamley et al[30]	Mental Illnesses	Compensatory CT	0.60	0.27-0.92	49.6
Total			1.21	0.98-1.43	100

CB: Cognitive behavior, CT: Cognitive training.

Table 7 Effect size of quality of life

Study	Diagnosis	Intervention	Effect size	95%CI	Weight (%)
Lee et al[33]	Psychosis	CBSS	0.45	0.40-0.50	60.4
Pijnenborg et al[28]	Psychosis	Socialcognitive group treatment	0.04	-0.03-0.10	38.7
Twamley et al[30]	Mental illnesses	Compensatory CT	0.96	0.53-1.38	0.9
Total			0.29	0.25-0.33	100

CBSS: Cognitive behavioral social skills, CT: Cognitive training.