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Internalized stigma reduces chances of clinical and subjective recovery in people with schizophrenia and other severe mental illness. To date, there is not enough evidence about an effective intervention to reduce internalized stigma that promotes clinical and subjective recovery in people with high internalized stigma and severe mental illness. The aim of this study was to evaluate the efficacy of a new psychological intervention named "Coping Internalized Stigma Program" (PAREI). An eight-session structured group-based integrative intervention was designed including psychoeducation, cognitive behavioural therapy, and mutual support. Fifty-four individuals with severe mental illness and a high level of internalized stigma were selected and randomly assigned to the PAREI intervention (n = 29) or to the control group (n = 25). The results of mixed ANOVAs revealed improvements in the PAREI group after treatment in the emotional dimension of internalized stigma, perceived legitimacy of discrimination, recovery expectations, and social functioning as compared to the control group. The results indicate that the PAREI represents a promising intervention tool to reduce internalized stigma, and to improve clinical and subjective recovery markers in people with severe mental illness and high internalized stigma.

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El estudio del estado cognitivo de las personas con Trastorno Mental Grave (TMG) ha cobrado relevancia por su capacidad tanto de pronosticar el rendimiento funcional, como la eficacia de las intervenciones psicosociales. Sin embargo mientras los estudios publicados se han centrado en personas con diagnósticos específicos, a la fecha no existen trabajos que comparen el grado y tipo de alteración en los procesos cognitivos en los principales diagnósticos incluidos en el TMG. Clarificar esta cuestión tendría un interés aplicado ya que permitiría mejorar tanto la evaluación como la rehabilitación en los recursos de rehabilitación psicosocial dirigidos fundamentalmente a personas con TMG. Por ello el objetivo del presente trabajo fue comparar las alteraciones cognitivas presentes en los principales diagnósticos incluidos en el TMG, i.e., esquizofrenia, trastorno bipolar, trastorno depresivo mayor y trastorno obsesivo compulsivo. Tras realizar una búsqueda en la base de datos PubMed se seleccionaron nueve meta-análisis actuales sobre alteraciones cognitivas en dichos diagnósticos. Los resultados mostraron que los cuatro diagnósticos comparten alteraciones moderadas-graves en atención, memoria operativa, memoria a largo plazo, funciones ejecutivas y velocidad de procesamiento, mostrando tamaños del efecto moderados-altos y observándose diferencias cuantitativas en la gravedad de las alteraciones entre los diagnósticos. Las mayores diferencias entre los diagnósticos en cuanto a la gravedad de las alteraciones se observó en cognición social siendo las personas con esquizofrenia las que presentaron dificultades más graves con un tamaño del efecto alto. El diagnóstico que tuvo alteraciones cognitivas menos graves fue el trastorno depresivo mayor mostrando tamaños del efecto moderados. Los cuatro diagnósticos compartieron alteraciones graves en control de la interferencia y flexibilidad cognitiva. Se discuten las implicaciones aplicadas para los recursos de rehabilitación así como sugerencias para futuras investigaciones

Cognitive impairment in Severe Mental Disorders (SMD) has critical importance due to its ability to predict functional performance, as well as the efficacy of psychosocial interventions. While there are previous studies about cognitive functioning on specific diagnoses, to date no works have compared cognitive impairment between the four main diagnosis included in the SMD. Clarifying this point has clinical implications to target assessment and interventions given that the recipients of many psychosocial rehabilitation services are people with SMD. The aim of the present study was to compare cognitive performance in the main diagnoses included in the SMD, i.e., schizophrenia, bipolar disorder, major depressive disorder, and obsessive-compulsive disorder, by means of a review of the existing literature. The results of the nine meta-analyses found showed that the four diagnoses shared moderate-severe impairment in attention, working memory, long-term memory, executive functions, and processing speed, (medium-large effect sizes), with quantitative differences in the comparison of the severity of the deficits between diagnoses. The largest differences between diagnoses regarding deficits severity were observed in social cognition, with people with schizophrenia presenting more severe impairment with larger effect sizes. The diagnosis that had less severe cognitive deficits was major depressive disorder showing medium effect sizes. The four diagnoses shared severe impairment in control of interference and cognitive flexibility. Implications for rehabilitation and guidelines for future research are discussed

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