***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: An emerging body of research has shown that computer-assisted cognitive remediation , consisting of training in attention , memory , language and /or problem-solving , produces improvement in neurocognitive function that generalizes to untrained neurocognitive tests and may also impact symptoms and work functioning in patients with schizophrenia . The active ingredient of these interventions , however , remains unknown as control groups in these studies have typically included few , if any , of the elements of these complex behavioral treatments . This study compared the effects of an extended ( 12-month ) , st and ardized , computer-assisted cognitive remediation intervention with those of a computer-skills training control condition that consisted of many of the elements of the experimental intervention , including hours spent on a computer , interaction with a clinician and non-specific cognitive stimulation .  Forty-two patients with schizophrenia were r and omly assigned to one of two conditions and were assessed with a comprehensive neuropsychological test battery before and after treatment . Results revealed that cognitive-remediation training produced a significant improvement in working memory , relative to the computers-skills training control condition , but that there was overall improvement in both groups on measures of working memory , reasoning/executive-function , verbal and spatial episodic memory , and processing speed . Taken together , these findings suggest that specific practice in neurocognitive exercises targeted at attention , memory and language , produce improvements in neurocognitive function that are not solely attributable to non-specific stimulation associated with working with a computer , interacting with a clinician or cognitive challenge , but that non-specific stimulation has a salutary effect on neurocognition as well CONTEXT Despite the availability of efficacious treatments , the long-term course of bipolar disorder is often unfavorable . OBJECTIVE To test the effectiveness of a multicomponent intervention program to improve the quality of care and long-term outcomes for persons with bipolar disorder . DESIGN R and omized controlled trial with allocation concealment and blinded outcome assessment . SETTING Mental health clinics of a group-model prepaid health plan . PATIENTS Of 785 patients in treatment for bipolar disorder who were invited to participate , 509 attended an evaluation appointment , 450 were found eligible to participate , and 441 enrolled in the trial . INTERVENTIONS Participants were r and omly assigned to a multicomponent intervention program or to continued care as usual . Three nurse care managers provided a 2-year systematic intervention program , including the following : a structured group psychoeducational program , monthly telephone monitoring of mood symptoms and medication adherence , feedback to treating mental health providers , facilitation of appropriate follow-up care , and as-needed outreach and crisis intervention . MAIN OUTCOME MEASURES In-person blinded research interviews every 3 months assessed mood symptoms using the Longitudinal Interval Follow-up Examination . Health plan administrative records were used to assess the use and cost of mental health services . RESULTS Intent-to-treat analyses demonstrated that the intervention significantly reduced the mean level of mania symptoms ( z = 2.09 , P = .04 ) and the time with significant mania symptoms ( 19.2 vs 24.7 weeks ; F(1 ) = 6.0 , P = .01 ) . There was no significant intervention effect on mean level of depressive symptoms ( z = 0.19 , P = .85 ) or time with significant depressive symptoms ( 47.6 vs 50.7 weeks ; F(1 ) = 0.56 , P = .45 ) . Benefits of the intervention were found only in a subgroup of 343 persons with clinical ly significant mood symptoms  at the baseline assessment . The incremental cost ( adjusted ) of the intervention was 1251 dollars ( 95 % confidence interval , 55 - 2446 dollars ) , including approximately 800 dollars for the intervention program services and an approximate 500 dollars increase in the costs of other mental health services . CONCLUSIONS Population -based systematic care programs can significantly reduce the frequency and severity of mania in bipolar disorder , and cost increases are modest considering the clinical gains . The incorporation of more specific cognitive and behavioral content or more effective medication regimens may be necessary to significantly reduce the symptoms of depression BACKGROUND Patient-clinician communication is central to mental healthcare but neglected in research . AIMS To test a new computer-mediated intervention structuring patient-clinician dialogue ( DIALOG ) focusing on patients ' quality of life and needs for care . METHOD In a cluster r and omised controlled trial , 134 keyworkers in six countries were allocated to DIALOG  or  treatment as usual ; 507 people with schizophrenia or related disorders were included . Every 2 months for 1 year , clinicians asked patients to rate satisfaction with quality of life and treatment , and request additional or different support . Responses were fed back immediately in screen displays , compared with previous ratings and discussed . Primary outcome was subjective quality of life , and secondary outcomes were unmet needs and treatment satisfaction . RESULTS Of 507 patients , 56 were lost to follow-up and 451 were included in intention-to-treat analyses . Patients receiving the DIALOG intervention had better subjective quality of life , fewer unmet needs and higher treatment satisfaction after 12 months . CONCLUSIONS Structuring patient-clinician dialogue to focus on patients ' views positively influenced quality of life , needs for care and treatment satisfaction Nonadherence to medication is a widespread problem in schizophrenia and is associated with poor clinical outcomes and inappropriate management and utilization of re sources . The aim of the current investigation was to assess the impact of telemonitoring of medication adherence on symptomatology and service use in patients with schizophrenia . A total of 108 schizophrenia patients were r and omized into three equal groups according to the approaches used to assess medication adherence ; self-report , pill counting , and telemonitoring . Telementoring was achieved through an innovative new platform called @HOME . This platform offers clinicians early warnings about impeding nonadherence as well as information about the pattern of medication taking . Patient 's adherence was observed over an 8-week period , during which patient 's clinical status and service use were recorded . In comparison to the other two groups , patients using @HOME showed improvement in the Global Clinical Impression Scale and a significant reduction in emergency visits and medical appointments . The @HOME platform was highly acceptable by patients , caregivers , and professionals , and required minimal training for implementation . The results of the study suggest that the use of telemonitoring in psychiatric setting s was both feasible and acceptable and may be associated with significant clinical and service related benefits INTRODUCTION Schizophrenic patients present cognitive dysfunctions which are regarded to be one of endophenotypical markers predisposing to schizophrenia . Currently , schizophrenia can be treated as a neurodegenerative and neurodeveloping disease with genetic background . OBJECTIVE Assessment of the possible positive effect of neuropsychological rehabilitation in schizophrenia , in patients presenting cognitive dysfunctions . An additional aim was to verify the hypothesis that some genetic polymorphisms can be a prognostic factor for success in neuropsychological rehabilitation . MATERIAL AND METHODS 41 participants and 40 control subjects were r and omly selected . Both groups had the diagnosis of paranoid schizophrenia .  Cognitive functions were checked with the  Wisconsin Card Sorting Test , Trail Making Test , and Stroop Test at the beginning and end of the experiment . In the research group , each patient trained with the rehabilitation programme RehaCom , whereas the control group did not receive such training . Genes COMT rs4680 and BDNF rs6265 were analysed in the genetic part of study . RESULTS RehaCom procedures appear to be useful in the neuropsychological rehabilitation of cognitive dysfunctions in patients diagnosed with schizophrenia . The research group showed a moderate improvement in the training programmes . Analysis of parameters obtained in the neuropsychological tests showed a slight improvement in both groups . At the present time , analysis of the polymorphisms of genes can not be treated as a prognostic factor for the success of neuropsychological rehabilitation because statistical analyses showed few dependences with little statistical significance . CONCLUSIONS Cognitive rehabilitation produces moderate improvement in cognitive functioning Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more OBJECTIVE There is considerable interest in cognitive remediation for schizophrenia . Our study aim ed to evaluate , in a large sample of patients with schizophrenia , the interest of a computer-assisted cognitive remediation program on cognitive performances of patients as well as in clinical and functional outcome . METHOD Seventy-seven patients with remitted schizophrenia were r and omly assigned to 14 2-hours individual sessions of computer-assisted cognitive remediation ( n=39 ) or a control condition ( n=38 ) . Remediation was performed using RehaCom ® software . Four procedures were chosen to train four cognitive functions involved in different stages of the information processing : attention/concentration , working memory , logic , and executive functions . Primary outcomes were remediation exercise metrics , neuropsychological composites ( episodic memory , working memory , attention , executive functioning , and processing speed ) , clinical and community functioning measures . RESULTS Cognitive performances concerning Attention/vigilance , verbal working memory and verbal learning memory and reasoning/problem solving improved significantly in the remediation condition when no difference was reported in the control condition between the 2 assessment s. However , there were no significant benefits of cognitive remediation on non-verbal working memory and learning and speed of processing or functional outcome measures . CONCLUSIONS Cognitive remediation for people with schizophrenia was effective in improving performance , but the benefits of training did not generalize to functional outcome measures . Long term follow-up studies are needed to confirm the maintenance of such improvements Computerized cognitive remediation has result ed in improved executive function in schizophrenia , whereas results with regard to verbal memory were inconsistent . In the present study , 42 in patients with schizophrenia were r and omly assigned to a computerized cognitive remediation group or to a  treatment-as-usual ( TAU ) control group . The remediation group received 15 sessions of computerized cognitive training ( Cogpack ) over a 3-week period . Neurocognitive functions were assessed at the beginning and end of this period . Compared to the control condition , remediation training result ed in improvements in verbal learning , processing speed and executive function ( verbal fluency ) . The results indicate that cognitive remediation may lead to improvements beyond those of executive function Abstract Objective . Adherence to prescribed antipsychotic medication is a major factor in achieving optimal long-term clinical outcomes . The aim of this study was to evaluate the impact of a telephone-based strategy provided by a nurse on adherence to antipsychotic treatment among patients with schizophrenia . Methods . A total of 928 clinical ly stable out patients with schizophrenia were r and omized to receive a monthly telephone call by a nurse or routine clinical care . Telephone calls were performed at weeks 4 , 8 , and 12 , consisting of a st and ardized interview to detect and assess therapeutic adherence and subjective attitude towards medication . Patients were followed for 4 months . A cut-point of ≥ 60 % of prescribed dose was used to classify patients as being adherent . Results . At week 16 , a significantly higher percentage of patients who received a telephone-based follow-up ( 96.7 % , n = 410 ) were classified as adherent compared to the control group ( 91.2 % , n = 402 ) ( P = 0.0007 ) . Patients in the intervention group were significantly more likely to be adherent than control group ( adjusted OR = 3.3 95 % CI 1.6–6.6 , P = 0.0001 ) . Conclusions . Telephone-based nursing strategy  showed a significant improvement in adherence to antipsychotic drugs . Further studies are necessary to confirm if this kind of intervention could be a complementary strategy to optimize adherence in patients with schizophrenia Although social skills training ( SST ) is an effective approach for improving social skills for schizophrenia , the motivational deficit attenuates its efficacy . Virtual reality ( VR ) applications have allowed individuals with mental disabilities to enhance their motivation for rehabilitation . We compared SST using VR role-playing ( SST-VR ) to SST using traditional role-playing ( SST-TR ) . This r and omized , controlled trial included 91 in patients with schizophrenia who were assigned to either  SST-VR ( n=46 ) or SST-TR ( n=45 ) . Both groups were administered over 10 semiweekly group sessions . An experienced , blinded rater assessed vocal , nonverbal and conversational skills . We also obtained data on motivation for SST and various social abilities . Throughout the 10 sessions , the SST-VR group ( n=33 ) showed greater interest in SST and generalization of the skills than the SST-TR group ( n=31 ) . After SST , the SST-VR group improved more in conversational skills and assertiveness than the SST-TR group , but less in nonverbal skills . The VR application in role-plays of SST for schizophrenia may be particularly beneficial in terms of improving the conversational skills and assertiveness , possibly through its advantages in enhancing motivation for SST and generalization of the skills , and thus it may be a useful supplement to traditional SST Deprivation of liberty ( DL ) in psychiatric inpatient care is common worldwide . As liberty is a central element of patients ’ rights , there is a need to develop most effective methods supporting patients ’ personal liberty . The article presents initial results from a 
    Output:
    
Computer-assisted cognitive rehabilitation  was effective in improving cognitive function .
Specific technology types have been found to be effective for some outcomes ( eg , telephone and remote medication monitoring for adherence to treatment ) , while other types of telehealth technologies ( eg , delivery of patient education using computers ) had no benefit over traditional nurse-based methods and were less acceptable to patients .