Adapted Cognitive/Affective Remediation for Cannabis Misuse in Schizophrenia
Condition: Schizophrenia; Schizoaffective Disorder
MeSH terms: Schizophrenia; Psychotic Disorders
Study type: Interventional
Phase: Phase 1/Phase 2

Summary: 
      This study will integrate and adapt a cognitive remediation (Cognitive Enhancement Therapy
      [CET]) and an affect regulation (Personal Therapy [PT]) intervention for 50 individuals with
      schizophrenia that misuse cannabis. Participants will be randomized to CET/PT plus treatment
      as usual (TAU) or TAU alone and treated for 18 months.
    

Detailed description: 
      Schizophrenia is a severe and chronic mental illness that places significant burden on the
      individuals who suffer from it, their families, and society. One of the most vexing problems
      in the treatment of schizophrenia is the high rate of substance use comorbidity. The majority
      of schizophrenia patients experience substantial cognitive and affective impairments.
      Consistent deficits have been observed in the broad domains of neurocognition(e.g.,
      attention, memory, and problem-solving), social cognition (e.g., perspective-taking,
      foresight, social cue recognition), and affect regulation, which are major contributors to
      functional impairment in the disorder. These cognitive and affective deficits may be
      exacerbated among schizophrenia patients that misuse substances and because these deficits
      are untreated by current pharmacotherapeutic strategies many turn to cannabis and other drugs
      to cope.

      Cognitive Enhancement Therapy (CET) is a treatment that has proved effective in improving
      cognition in individuals with schizophrenia. Personal Therapy (PT) is a treatment designed to
      help individuals with the affective deficits that may lead to substance misuse for
      individuals with schizophrenia. This study will adapt and integrate CET and PT to test
      whether this intervention is better or more effective for treating substance misusing
      schizophrenia patients than the usual treatment received (Treatment as Usual or TAU).

      Participation in this study will last 18 months. Eligible participants will be randomly
      assigned to receive either CET/PT or TAU. Participants that receive the CET/PT condition must
      be able to attend weekly treatment sessions in Pittsburgh, PA. All participants will complete
      cognitive, functional, and affective outcome measures at the beginning of the study,
      6-months, 12-months, and at 18-months regardless of treatment assignment. Results from all
      outcome measures will be used to estimate the effectiveness of CET/PT for individuals that
      have schizophrenia and misuse substances.
    

Intervention name(s): CET/PT; Treatment as Usual
Intervention type(s): Behavioral; Behavioral
Intervention description(s): CET/PT is an 18-month comprehensive small group approach for the remediation of cognitive deficit in schizophrenia consisting of individual sessions and 45 group training sessions in social cognition that are integrated with an affect regulation approach and 60 hours of computer assisted training in attention, memory, and problem solving skills.; The usual care individuals with schizophrenia that misuse substances receive in the community for their conditions.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Schizophrenia; Schizoaffective Disorder; Cannabis; Alcohol; Substance Misuse; Cognition; Psychosocial Treatment; Cognitive Enhancement Therapy; Personal Therapy; Treatment as Usual