Improving Facial Emotion Recognition in Schizophrenia: a Controlled Study Comparing Specific and Attentional Focused Cognitive Remediation

Baptiste Gaudelus, Jefferson Virgile, Sabrina Geliot, GAÏA/RECOS Study Team, Nicolas Franck, M Dupuis, C Hochard, A C Josserand, A Koubichkine, T Lambert, M Perez, B Rouyre, P Scherding, M C Bralet, C Demily, C Launay, B Gouache, C Duboc, A Dubrulle, S L Farhat, A Fourt, C Fluttaz, E Peyroux, A Todd, Baptiste Gaudelus, Jefferson Virgile, Sabrina Geliot, GAÏA/RECOS Study Team, Nicolas Franck, M Dupuis, C Hochard, A C Josserand, A Koubichkine, T Lambert, M Perez, B Rouyre, P Scherding, M C Bralet, C Demily, C Launay, B Gouache, C Duboc, A Dubrulle, S L Farhat, A Fourt, C Fluttaz, E Peyroux, A Todd

Abstract

Cognitive impairments associated with schizophrenia are very frequent. They concern both neurocognition and social cognition, including facial emotion recognition. These impairments have a negative impact on the daily functioning, in particular the social and vocational rehabilitation of people with schizophrenia. Previous studies in this area clearly demonstrated the interest of cognitive remediation to improve neurocognitive and social cognitive functioning in schizophrenia. They also established clear links between facial emotion recognition skills and attentional processes. The present study compares the GAÏA s-face program (GAÏA arm), which focuses on facial emotion recognition processes, with the RECOS program (RECOS arm), a neurocognitive remediation therapy focusing on selective attention. Forty people with schizophrenia were randomly distributed between each study arm and assessed pre- (T1) and post- (T2) therapy. The single-blind assessment focused on facial emotion recognition (the main criteria), symptoms, social and subjective functioning, and neurocognitive and social cognitive performance. Both programs were conducted by nurses after a 3-day training session. The study showed a significant improvement in facial emotion recognition performance in both groups, with a significantly larger effect in the GAÏA arm. Symptoms and social functioning also improved in the GAÏA arm, and certain neurocognitive and social cognitive processes improved in both study arms. Further studies are recommended, with larger population samples and a follow-up assessing the long-term preservation of these improvements.

Keywords: Schizophrenia; cognitive remediation; facial emotions; nursing practice; social cognition.

Figures

Figure 1
Figure 1
Group allocation.
Figure 2
Figure 2
Steps of GAÏA and RECOS interventions.
Figure 3
Figure 3
Evolution of TREF scores pre/post intervention.
Figure 4
Figure 4
Evolution of PANSS scores, groups comparison.
Figure 5
Figure 5
Evolution of social autonomy, EAS scores pre/post intervention.

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