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Resumen El objetivo de este estudio fue realizar una evaluación preliminar de la terapia de remediación cognitiva (TRE) en una paciente con bulimia nerviosa (BN). Bajo un diseño pre-post-tratamiento, la paciente (20 años de edad e índice de masa corporal [IMC] de 22.41) completó cuatro pruebas neuropsicológicas, tres medidas de síntomas de BN y dos de sintomatología psiquiátrica (depresión y ansiedad). Con base a las puntuaciones pre y post TRE fue calculado el cambio clínico objetivo (CCO). Los principales efectos neuropsicológicos se registraron en: flexibilidad de pensamiento, proceso visocontructivo, coherencia central y planificación (CCO = 0.39-0.99). También se identificaron cambios relevantes en las medidas de sintomatología psiquiátrica y de BN (CCO = 0.53-0.88), no así en el IMC. Este estudio suma evidencias respecto a la utilidad de la CRT en el tratamiento multidisciplinario, ya no solo de la anorexia nerviosa, sino que extiende su aplicabilidad a la BN.

Abstract The aim of this study was to perform a preliminary evaluation of cognitive remediation therapy (CRT) in a patient with bulimia nervosa (BN). The participant was 20 years old with a 22.41kg/m2 body mass index (BMI). Under a pre-post treatment design, the patient was administered four neuropsychological tests, three measures of BN symptoms and two of psychiatric symptomatology (depression and anxiety). Based on the pre and post CRT scores, the objective clinical change (OCC) was calculated. The main neuropsychological effects were observed in cognitive flexibility, visoconstructive processing (memory and central coherence) and working memory (OCC = 0,39-0,99). Relevant changes were also identified in the measures of psychiatric symptomatology and BN (OCC = 0,53-0,88), with no change in BMI. This study adds evidence regarding the usefulness of CRT in the multidisciplinary treatment not only of anorexia nervosa, but also extends its applicability to another eating disorder, BN.

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A significant percentage of people with bipolar disorder (BD) exhibit suboptimal functional adjustment, even when appropriately treated and after symptomatic recovery is achieved. Given that cognitive impairment is one of the strongest correlates of socio-occupational outcomes and quality of life in BD, cognitive remediation (CR) is currently acknowledged as a promising treatment that could help bridge the gap between symptomatic and full functional recovery. The aim of this review was to explore the efficacy of CR approaches in improving cognitive and functional outcomes in BD patients. PubMed, PsycINFO, and CENTRAL were searched from inception to November 2022. Randomized controlled trials exploring the effects of CR on cognition and/or functional adjustment in adult BD patients were eligible. Ten studies based on seven independent trials (n = 586) were included. Change-score effect sizes (Hedges' g) were obtained for efficacy outcome measures and combined by means of meta-analytic procedures. Small but significant overall effects were observed for working memory (g = 0.32, 95% CI 0.11-0.52), planning (g = 0.30, 95% CI 0.03-0.56), and verbal learning (g = 0.40, 95% CI 0.15-0.66). However, CR was not found to exert any significant effects on functional outcomes at treatment completion or at follow-up assessment. Although CR may modestly enhance the cognitive performance of BD patients, this effect does not translate into an improvement at the functional level. The current data do not support the inclusion of CR as a treatment recommendation in clinical practice guidelines for the management of BD.

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Background: Cognitive Remediation Therapy (CRT) is a psychological treatment which aims to improve the neurocognitive processes that interfere with the daily functioning of individuals and has proven to be useful in the treatment of obesity. This therapy has been implemented in some countries as a co-adjuvant treatment for people with obesity, but it has not been tested in Mexico, where obesity is one of the main public health problems, so it is essential to implement more studies of this type to obtain effective treatments to control weight. Objective: To describe the research procedure of a multidisciplinary intervention protocol for adults with obesity in a randomized controlled clinical trial. Method: Participants will be adults from 19 to 60 years of age with obesity, who will be randomly assigned to experimental and control groups. The control group will receive intervention only after the experimental group has completed the intervention program. Measurements of body composition, nutritional state, psycho-physiological and physical activities of the participants will be obtained before and after the intervention, with a three-month follow-up after the intervention has concluded. Conclusion: Results of this study will provide useful evidence for the implementation and follow-up of a multidisciplinary intervention with CRT to promote a better efficacy in the treatment and control of obesity.

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Objective The purpose is to present a neuropsychological intervention program, aimed at the broader person, the Psychoeducation Module, directed fundamentally at one's support network, family members and even intervention agents. Method The Cognitive Rehabilitation Program, given the acronym REHACOG, can work as a remedial and/or preventive tool that is very structured but flexible and complete because it includes varied tasks that promote multiple cognitive, linguistic and socio-emotional processes. REHACOG has an active character, also having a module more oriented to information and awareness for all the themes inherent to the larger individuals, potentially more oriented to caregivers or the elderly support network. Results Emphasizing this last topic, which has not yet been disseminated, which is the main objective of this article, we present the training module and the psychoeducational module, which includes six rubrics that cover topics ranging from conceptualization(s) of dementia, neurocognitive disorders, to symptomatology, assessment, intervention, caregivers and their roles, and response resources. Conclusion Although this material has not yet been published and disseminated, we expect to use and test it very soon.We look forward to its usefulness among professionals and future professionals in the area.

Objetivo Apresentar um programa de intervenção neuropsicológica, orientado para a pessoa maior, especificamente, o módulo Psicoeducação, vocacionado, fundamentalmente, para a sua rede de suporte, familiares e mesmo agentes interventores. Método O Programa de Reabilitação Cognitiva, com acrónimo REHACOG, pode funcionar enquanto ferramenta remediativa e/ou preventiva, bastante estruturado, mas flexível, porque inclui inúmeras e variadas tarefas promotoras de múltiplos processos cognitivos, linguísticos e socio emocionais. Genericamente, o REHACOG tem caráter ativo, possuindo, também, um módulo mais orientado para a informação, divulgação e sensibilização para todas as temáticas inerentes aos indivíduos maiores, potencialmente, mais orientado para os cuidadores ou rede de suporte dos idosos. Resultados Enfatizando este último tópico, ainda não disseminado, maior objetivo do presente artigo, temos o módulo informativo/formativo, Módulo Psicoeducativo, que contempla seis rubricas que perpassam tópicos desde a concetualização(ões) de demência, os transtornos neurocognitivos, à sintomatologia, à avaliação, à intervenção, aos cuidadores e seus papéis e aos recursos de resposta. Conclusão Embora este material ainda não esteja publicado e disseminado, contamos vir a utilizá-lo e a testá-lo muito em breve. Almejamos a sua utilidade junto de profissionais e futuros profissionais da área.

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Background: Cognitive retraining or remediation approaches dispense high levels of stimulation and new learning tasks, leading to an increased neural connections, which facilitate rapid recovery in patients with neurological as well as psychiatric conditions. Objectives: The current study aimed to investigate the effect of cognitive retraining (CR) in depressive disorders. We assigned 40 patients with mild to moderate depression to two sample groups, with 20 participants each: CR alone and CR with medicine. A 6-week CR module was delivered, and participants' scores on measures such as the Beck Depression Inventory-II, Metacognition Questionnaire 30, World Health Organization Quality of Life- Brief, and Global Assessment of Functioning were compared. Results: Analysis using Stata/IC version 16 included descriptive statistics, paired and independent t-tests, analysis of covariance, and propensity score matching. Cohen's d was computed to determine the effect size. Within-group analysis revealed statistically significant differences in pre-post scores of the outcome measures (p < .05) and large effect size (d = 3.41; d = 3.60) in both groups. The difference in scores of outcome measures between the groups was not significant (p > .05) even when covariates were controlled, or nearest neighbor match analysis was carried out. CR is effective in alleviating symptoms and dysfunctional metacognitive beliefs in addition to enhancing functioning and quality of life. Conclusions: CR-based interventions may be essential mental health services owing to growing research in psychotherapy via virtual modes such as tele- and video-conferencing. These interventions can substantiate both prevention and remedy. (AU)

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ABSTRACT Objective: to analyze Cognitive Stimulation techniques effectiveness in the community and at home, in people with stabilized mental illness and their families. Method: an Integrative Literature Review, with inclusion criteria for primary studies that assess the Cognitive Stimulation techniques effectiveness in people with stable mental illness, older than 18 years, in the community and at home. Six articles were selected. Results: improvement of cognitive abilities such as attention, work memory and executive functions was observed. No conceptual differences or results were found among Cognitive Stimulation programs for people with different pathologies; computer tools are increasingly being used; sample size is limiting gain analysis; the nurse's role has not been clarified; family gains were not studied. Final considerations: the results obtained in this review reveal the need to know more about the theme.

RESUMEN Objetivo: analizar la efectividad de las técnicas de Estimulación Cognitiva en el contexto de la comunidad y el hogar en la persona con enfermedad mental estabilizada y sus familias. Método: Revisión Integrativa de la Literatura, con los criterios de inclusión como estudios primarios que evalúan la efectividad de las técnicas de Estimulación Cognitiva en personas con enfermedad mental estable, mayores de 18 años, en la comunidad y en el hogar. Se seleccionaron seis artículos. Resultados: se observó una mejora de las capacidades cognitivas como la atención, la memoria de trabajo y las funciones ejecutivas; no se encontraron diferencias conceptuales ni resultados entre los programas de Estimulación Cognitiva para personas con diferentes patologías; las herramientas informáticas son cada vez más utilizadas el tamaño de las muestras está limitando el análisis de las ganancias; el papel de la enfermera no ha sido aclarado; Las ganancias para las familias no fueron estudiadas. Consideraciones finales: los resultados obtenidos en esta revisión revelan la necesidad de saber más sobre el tema.

RESUMO Objetivo: analisar a efetividade das técnicas de Estimulação Cognitiva em contexto comunitário e domiciliário, na pessoa com doença mental estabilizada e suas famílias. Método: Revisão Integrativa da Literatura, tendo como critérios de inclusão estudos primários que avaliem a efetividade das técnicas de Estimulação Cognitiva em pessoas com doença mental em fase estável, com idade superior a 18 anos, na comunidade e domicílio. Foram selecionados seis artigos. Resultados: verificou-se melhoria de capacidades cognitivas como atenção, memória de trabalho e funções executivas; não se apuraram diferenças conceptuais, nem nos resultados, entre os programas de Estimulação Cognitiva para pessoas com diferentes patologias; as ferramentas informáticas são cada vez mais utilizadas; o tamanho das amostras é limitador da análise dos ganhos; o papel do enfermeiro não foi esclarecido; os ganhos para as famílias não foram estudados. Considerações finais: os resultados obtidos nesta revisão revelam a necessidade de se conhecer mais sobre a temática.

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The purpose of this study was to conduct a preliminary evaluation of cognitive remediation therapy (CRT) as part of the treatment of a patient with anorexia nervosa (AN) from Mexico. The participant was a 21-year-old woman with a body mass index (BMI) of 14.7, who had suffered from the disorder for 10 years. Using a pre-post treatment design, changes were evaluated using four neuropsychological tests, two tests to measure the AN symptoms and two to measure psychological distress (depression and anxiety). BMI was also evaluated before and after the intervention. The results of the present study were similar to those reported for patients from English-speaking countries. The average percentage of favorable change in the different measures was higher than 30%, except for BMI, which increased by only 21%. The results suggest that the inclusion of CRT in AN treatment programs in Mexico is a potentially viable option.

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Resumen Estudios previos han indicado la utilidad de la terapia de remediación cognitiva (TRC) en pacientes con trastornos de conducta alimentaria (TCA). El objetivo de este estudio fue evaluar una nueva técnica de innovación cognitiva llamada "Con la cabeza en las nubes" (CCN). Participaron 22 mujeres con TCA (13 con anorexia nerviosa y 9 con bulimia nerviosa), de entre 14 y 29 años de edad (M = 19.0, DE = 3.4), quienes completaron las seis sesiones grupales de que consta dicha técnica. Bajo un diseño pre-post intervención, las participantes fueron evaluadas en cuanto a: funciones viso-constructivas (Copia de la Figura Compleja de Rey-Osterrieth [CFCR]), pensamiento creativo (Test de Pensamiento Creativo de Torrance [TPCT]), flexibilidad cognitiva (CFCR y TPCT) y control cognitivo (Test de Stroop). La intervención generó una mejora en distintos dominios cognitivos, como son: mayor coherencia global, pensamiento creativo y resistencia al cierre, así como menor fragmentación. Basada en la TRC, encaminada a estimular el procesamiento novedoso de estímulos visuales, la técnica CCN mostró mejorar algunos de los procesos cognitivos implicados en la generación de los síntomas de pacientes con TCA.

Abstract Previous studies have shown the usefulness of cognitive remediation therapy (CRT) in patients with eating disorders (ED). The objective of this study was to assess a new cognitive technique called "With the head in the clouds" (WHC). A total of 22 women with ED (13 with anorexia nervosa and nine with bulimia nervosa), between 14 and 29 years (M = 19.0, SD = 3.4), completed the six group sessions of this technique. Under a design pre-post intervention, participants were assessed in: visuo-constructive functions (Copy of the Rey-Osterrieth Complex Figure [CRCF]), creative thinking (Torrance Creative Thinking Test [TCTT]), cognitive flexibility (CRCF and TCTT), and cognitive control (Stroop Test). The intervention improved different cognitive domains, such as: greater global coherence, creative thinking and resistance to closure, as well as less fragmentation. Based on CRT, aimed at stimulating the new processing of visual stimuli, the technique WHC showed an improvement in some of the cognitive processes involved in the onset of symptoms in patients with ED.

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Cognitive remediation is a promising approach to treating core cognitive deficits in adults with autism, but rigorously controlled trials of comprehensive interventions that target both social and non-social cognition over a sufficient period of time to impact functioning are lacking. This study examined the efficacy of cognitive enhancement therapy (CET) for improving core cognitive and employment outcomes in adult autism. Verbal adult outpatients with autism spectrum disorder (N = 54) were randomized to an 18-month, single-blind trial of CET, a cognitive remediation approach that integrates computer-based neurocognitive training with group-based training in social cognition, or an active enriched supportive therapy (EST) comparison focused on psychoeducation and condition management. Primary outcomes were composite indexes of neurocognitive and social-cognitive change. Competitive employment was a secondary outcome. Intent-to-treat analyses indicated that CET produced significant differential increases in neurocognitive function relative to EST (d = .46, P = .013). Both CET and EST were associated with large social-cognitive improvements, with CET demonstrating an advantage at 9 (d = .58, P = 0.020), but not 18 months (d = .27, P = 0.298). Effects on employment indicated that participants treated with CET were significantly more likely to gain competitive employment than those in EST, OR = 6.21, P = 0.023, which was mediated by cognitive improvement. CET is a feasible and potentially effective treatment for core cognitive deficits in adult autism spectrum disorder. The treatment of cognitive impairments in this population can contribute to meaningful improvements in adult outcomes. Autism Res 2018, 11: 519-530. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Cognitive enhancement therapy (CET), an 18-month cognitive remediation intervention designed to improve thinking and social understanding, was found to be more effective than supportive therapy at improving mental quickness, attention, and employment in adults living with autism. Social understanding was equally improved in CET and supportive therapy. Cognitive remediation interventions are feasible and may confer significant functional benefits to adults with autism.

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