Cognitive impairment substantially contributes to functional disability in schizophrenia. Methods to improve functioning in long-term hospitalized patients are lacking. Cognitive Adaptation Training (CAT) improves functional outcomes in schizophrenia outpatients living in the US.

To investigate the efficacy of CAT in long-term hospitalized schizophrenia patients living in the Netherlands.

Twenty schizophrenia inpatients participated in this study. Ten patients received treatment as usual (TAU), the other 10 patients received TAU plus CAT. CAT uses environmental supports (e.g. calendars, alarm clocks) in order to compensate the impact of cognitive impairment. CAT was provided for 8 months. Assessments of the Multnomah Community Ability Scale (MCAS) and SOFAS were conducted at baseline, halfway, and after 8 months. In addition, participation in work-related activities (e.g. woodworking, graphic center) was recorded every month for a duration of 12 months. Anayses of mixed models were conducted, using the baseline score as a covariate.

After 6 months, CAT patients spent significantly more partial days at activity centers, compared to TAU patients. Differences remained significant after 12 months. With regard to the other measures, CAT patients showed improvement on the SOFAS and the MCAS after 8 months (trend) with a large effect size (0.8).

These findings suggest that inpatients with schizophrenia may benefit from CAT. In particular, the method may be effective to increase productivity in this chronic population. These results are promising, research with a larger sample size is needed to further investigate the effect of CAT in long-term hospitalized psychiatric patients.