***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND The Early Detection and Intervention Programme of the German Research Network on Schizophrenia ( GRNS ) investigates the initial prodromal phase of psychosis in a multidimensional approach . Two intervention strategies are being studied by two large-scale multicentre projects . AIMS To present the concept of the intervention studies , and to provide an interim report of the recruitment procedure . METHOD Comprehensive cognitive-behavioural therapy has been developed for patients in the " early initial prodromal state " . For patients in the " late initial prodromal state " the atypical neuroleptic amisulpride is explored . Both interventions are evaluated in r and omised controlled trials using clinical management as the control condition . RESULTS Between January 2001 and March 2003 , 1212 individuals seeking help for mental health problems were screened for putative prodromal symptoms at four university centres . More than 388 individuals fulfilled criteria for both interventions and 188 ( 48.5 % ) gave informed consent to participate in the trials . CONCLUSIONS The screening procedure appears to be feasible and trial participation seems to be acceptable to a relevant proportion of people at increased risk of developing psychosis BACKGROUND Young people with self-experienced cognitive thought and perception deficits ( basic symptoms ) may present with an early initial prodromal state ( EIPS ) of psychosis in which most of the disability and neurobiological deficits of schizophrenia have not yet occurred . AIMS To investigate the effects of an integrated psychological intervention ( IPI ) , combining individual cognitive-behavioural therapy , group skills training , cognitive remediation and multifamily psychoeducation , on the prevention of psychosis in the EIPS . METHOD A r and omised controlled , multicentre , parallel group trial of 12 months of IPI v. supportive counselling ( trial registration number : NCT00204087 ) . Primary outcome was progression to psychosis at 12- and 24-month follow-up . RESULTS A total of 128 help-seeking out- patients in an EIPS were r and omised .  Integrated psychological intervention was superior to supportive counselling in preventing progression to psychosis at 12-month follow-up ( 3.2 % v. 16.9 % ; P = 0.008 ) and at 24-month follow-up ( 6.3 % v. 20.0 % ; P = 0.019 ) . CONCLUSIONS Integrated psychological intervention appears effective in delaying the onset of psychosis over a 24-month time period in people in an EIPS Impairments in social cognition are common in schizophrenia and predict poor functional outcome . The purpose of this proof-of-concept r and omized , parallel group clinical trial was to assess whether intranasal oxytocin ( OT ) , given before social cognitive training , enhances learning of social cognitive skills .  Twenty seven male out patients with schizophrenia participated in a 6-week ( 12 session ) training on social cognitive skills . Training focused on three domains : facial affect recognition , social perception , and empathy . Subjects were r and omly assigned ( double blind ) to receive either intranasal OTor placebo 30 min before each session . Participants did not receive OT between sessions or on the day of assessment s. We evaluated scores on social-cognition measures , as well as clinical symptoms and neurocognition , at baseline , 1 week following the final training session , and 1 month later . Our prespecified primary outcome measure was a social-cognition composite score comprised of five individual measures . There were main effects of time ( indicating improvement across the combined-treatment groups ) on the social-cognition composite score at both 1 week and 1 month following completion of training . Subjects receiving OT demonstrated significantly greater improvements in empathic accuracy than those receiving placebo at both posttreatment and 1 month follow up . There were no OT-related effects for the other social cognitive tests , clinical symptoms , or neurocognition . This study provides initial support for the idea that OT enhances the effectiveness of training when administered shortly before social cognitive training sessions . The effects were most pronounced on empathic accuracy , a high-level social cognitive process that is not easily improved in current social cognitive remediation programs Objective : Among individuals at clinical high risk ( CHR ) for psychosis , processing speed ( PS ) has been related to social and role functioning regardless of conversion to schizophrenia . This information processing dysfunction is a gateway to broader behavioral deficits such as difficulty executing social behaviors . We examined the feasibility of improving information processing relevant to social situations in CHR , including its sustainability at 2-month follow-up , and its association with concurrent social function . Method : This was a double-blind RCT in which 62 CHR participants were r and omized to Processing Speed Training ( PST ) or an active control  matched for training format and the same dose and duration of treatment . PST is a tablet-based program that uses pupillometry-based neurofeedback to continually adjust training parameters for an optimal neurocognitive load and to improve visual scanning efficiency by inhibiting selection of nonessential targets and discriminating figure-ground details . Results : The PST group showed faster motoric and nonmotoric PS at post training and 2-month follow-up . At 2 month follow-up , the PST group reported better overall social adjustment . Changes in PS from baseline to 2 months were correlated with overall social adjustment and social avoidance in the entire sample . Conclusions and Implication s for Practice : This is the first study to test focal neurofeedback-based cognitive training for PS deficits in the putatively prodromal phase of schizophrenia to address associated social morbidity . Targeting PS appears to be a promising pathway to decreasing comorbidity and mitigating a risk factor for psychosis BACKGROUND Schizophrenia is characterized by profound and disabling deficits in the ability to recognize emotion in facial expression and tone of voice . Although these deficits are well documented in established schizophrenia using recently vali date d tasks , their predictive utility in at-risk population s has not been formally evaluated . METHOD The Penn Emotion Recognition and Discrimination tasks , and recently developed measures of auditory emotion recognition , were administered to 49 clinical high-risk subjects prospect ively followed for 2 years for schizophrenia outcome , and 31 healthy controls , and a developmental cohort of 43 individuals aged 7 - 26 years . Deficit in emotion recognition in at-risk subjects was compared with deficit in established schizophrenia , and with normal neurocognitive growth curves from childhood to early adulthood . RESULTS Deficits in emotion recognition significantly distinguished at-risk patients who transitioned to schizophrenia . By contrast , more general neurocognitive measures , such as attention vigilance or processing speed , were non-predictive . The best classification model for schizophrenia onset included both face emotion processing and negative symptoms , with accuracy of 96 % , and area under the receiver-operating characteristic curve of 0.99 . In a parallel developmental study , emotion recognition abilities were found to reach maturity prior to traditional age of risk for schizophrenia , suggesting they may serve as objective markers of early developmental insult . CONCLUSIONS Profound deficits in emotion recognition exist in at-risk patients prior to schizophrenia onset . They may serve as an index of early developmental insult , and represent an effective target for early identification and remediation . Future studies investigating emotion recognition deficits at both mechanistic and predictive levels are strongly encouraged OBJECTIVE The early application of cognitive rehabilitation may afford long-term functional benefits to patients with schizophrenia . This study examined the two-year effects of an integrated neurocognitive and social-cognitive rehabilitation program , cognitive enhancement therapy ( CET ) , on cognitive and functional outcomes in early-course schizophrenia . METHODS Early-course out patients ( mean+/-SD illness duration = 3.19+/-2.24 years ) with schizophrenia or schizoaffective disorder were r and omly assigned to CET ( N=31 ) or enriched supportive therapy ( EST ) ( N=27 ) , an illness management intervention utilizing psychoeducation and applied coping strategies , and treated for two years . Multivariate composite indexes of cognitive , social adjustment , and symptom domains were derived from assessment batteries administered annually by computer-based tests and raters not blind to treatment assignment . RESULTS Of the 58 participants who were r and omly assigned and treated , 49 and 46 completed one year and two years of treatment , respectively . Intent-to-treat analyses showed significant differential effects favoring CET on social cognition , cognitive style , social adjustment , and symptomatology composites during the first year of treatment . After two years , moderate effects ( d=.46 ) were observed favoring CET for enhancing neurocognitive function . Strong differential effects ( d>1.00 ) on social cognition , cognitive style , and social adjustment composites remained at year 2 and also extended to measures of symptomatology , particularly negative symptoms . CONCLUSIONS CET appears to be an effective approach to the remediation of cognitive deficits in early schizophrenia that may help reduce disability in this population . The remediation of such deficits should be an integral component of early intervention programs treating psychiatrically stable schizophrenia out patients Background Cognitive deficits are a distinct feature among people at ultra-high risk ( UHR ) for psychosis and pose a barrier to functional recovery . Insufficient evidence exists on how to ameliorate these cognitive deficits in patients at UHR for psychosis and hence improve daily living and quality of life . The aim of the trial is to investigate whether cognitive remediation can improve cognitive and psychosocial function in patients at UHR for psychosis . Methods The FOCUS trial ( Function and Overall Cognition in Ultra-high risk States ) is a r and omised , parallel group , observer-blinded clinical trial enrolling 126 patients meeting the st and ardised criteria of being at UHR for psychosis . Patients are recruited from psychiatric in- and outpatient facilities in the Copenhagen catchment area . Patients are r and omised to one of the two treatment arms : cognitive remediation plus st and ard treatment versus st and ard treatment . The cognitive remediation consists of 24 weekly group-based and manualised sessions targeting neurocognition and social cognition . In addition to the group sessions , the patients will be offered 12 individual sessions aim ing at maximising the transfer of the effects of the cognitive training to their everyday lives . Follow-up assessment s will be conducted at 6 and 12 months after r and omisation . The primary outcome is the composite score on the Brief Assessment of Cognition in Schizophrenia at cessation of treatment after 6 months . Secondary outcomes are social and daily functioning , psychosis-like symptoms , negative symptomatology , and depressive symptomatology as measured with the Personal and Social Performance Scale , Brief Psychiatric Rating Scale-Exp and ed Version , Scale for the Assessment of Negative Symptoms , and the Montgomery-Åsberg Depression Rating Scale . Discussion This is the first trial to evaluate the effects of neurocognitive and social cognitive remediation in UHR patients . The FOCUS trial results will provide evidence on the effect of targeted and comprehensive cognitive rehabilitation on cognition , daily living , and symptomatology as well as long-term outcome in preventing transition to psychosis in UHR patients .Trial registration Clinical Trials.gov NCT 02098408 . Date of registration 18 March 2014 BACKGROUND New cognitive treatments for schizophrenia are needed that drive persistent gains in cognition and functioning . Using an innovative neuroplasticity-based cognitive training approach , we report our interim findings on the effects on cognition and functional outcome at 6 months after treatment . METHODS Thirty-two clinical ly stable schizophrenia subjects were r and omly assigned to either targeted cognitive training ( TCT , N = 22 ) or a computer games ( CGs ) control condition ( N = 10 ) . Twelve TCT subjects completed 50 hours of auditory based training ; 10 TCT subjects completed an additional 50 hours of training targeting visual and cognitive control processes . Subjects were assessed on neurocognition and functional outcome after training and at 6-month follow-up . RESULTS Both TCT subject groups showed significant durable gains at 6 months on measures of verbal learning/memory and cognitive control . Only TCT subjects who completed 100 hours of training showed durable gains on processing speed and global cognition , with nonsignificant improvement in functional outcome . Improved cognition was significantly associated with improved functional outcome at 6 months for TCT subjects . CONCLUSIONS A total of 50 hours of neuroplasticity-based computerized cognitive training appears sufficient to drive improvements in verbal learning/memory and cognitive control that endure 6 months beyond the intervention , but a higher " dose " and more " broad-spectrum " training may be necessary to drive enduring gains in processing speed and global cognition . Training-induced cognitive improvement is related to enhanced functioning at 6 months . These data suggest that ( 1 ) higher and " broader " doses of cognitive training may confer the most benefits for schizophrenia patients ; ( 2 ) the posttraining period opens a critical window for aggressive adjunctive psychosocial rehabilitation OBJECTIVE Impaired verbal memory in schizophrenia is a key rate-limiting factor for functional outcome , does not respond to currently available medications , and shows only modest improvement after conventional behavioral remediation . The authors investigated an innovative approach to the remediation of verbal memory in schizophrenia , based on principles derived from the basic neuroscience of learning-induced neuroplasticity . The authors report interim findings in this ongoing study . METHOD Fifty-five clinical ly stable schizophren 
    Output:
    
The current state of evidence indicates an effect of cognitive remediation on cognition and functioning in ultra-high risk individuals .