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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S8–S52

Disclosure of interest

The authors declare that they have no com-

peting interest.

Symposium: Cognitive remediation and

integrated treatments in the psychoses: Clinical

effects and biological correlates


Cognitive dysfunctions in the

psychoses and their impact on

patients’ social functioning

A. Mucci

, S. Galderisi

University of Campania “Luigi Vanvitelli”, Department of Psychiatry,

Naples, Italy

Corresponding author.


Impairment of neurocognitive functions, such as

attention, memory or executive functions, as well as of social

cognition, particularly of affect recognition and theory of mind,

are frequently observed in people with Schizophrenia or other

psychotic disorders. These dysfunctions are associated with poor

real-life functioning. Social cognition deficits mediate in part the

impact of neurocognitive dysfunction on functional outcome.


To review literature findings on prevalence, severity and

association with functional outcome of neurocognitive and social

cognitive deficits in schizophrenia and other psychotic disorders.


We searched PubMed for English/Italian or French full-

text publications with the keywords.




function”/learning/”social cognition”/”theory of mind”/”affect

recognition”/”acial emotion recognition”/”emotional intelli-

gence”/”emot* recognition”. Furthermore, we manually searched

the reference lists of relevant papers, systematic reviews and



In people with schizophrenia, schizoaffective disorder or

bipolar disorder with psychotic features, neurocognitive and social

cognition deficits were observed in all phases of the disorders, even

after symptom remission. Some of these deficits were observed

in subjects at high-risk to develop schizophrenia before psychotic

onset. In all these subjects, cognitive deficits are associated with

worse psychosocial functioning and poor quality of life. Pharma-

cological treatments do not alleviate cognitive deficits, which can

also limit the benefit of other psychological or psychosocial inter-



Neurocognitive and social cognition deficits need to

be targeted by specific interventions to improve real-life function-

ing and quality of life of people with schizophrenia or psychotic


Disclosure of interest

AM received honoraria or advisory

board/consulting fees from the following companies: Janssen

Pharmaceuticals, Otsuka, Pfizer and Pierre Fabre.

SG received honoraria or advisory board/consulting fees from

the following companies: Lundbeck, Janssen Pharmaceuticals,

Hoffman-La Roche, Angelini-Acraf, Otsuka, Pierre Fabre and



Biological correlates of the effects of

cognitive remediation in the


R. Penades

Hospital Clinic Barcelona, Department of Psychiatry and Clinical

Psychobiology, Barcelona, Spain

Cognitive Remediation Therapy (CRT) deals with the cognitive

impairment, which is one of the most disabling symptoms of

schizophrenia. Unfortunately, the understanding of its neurobio-

logical correlates is far from complete. Neuroimaging studies have

shown that CRT is able to induce neurobiological changes although

the results have not always been enough replicated. The most

commonly reported changes were those that involved the pre-

frontal and thalamic regions. Additionally, structural changes were

described in both the grey and white matter, suggesting a neuro-

protective effect of cognitive remediation. Neuroimaging studies

of cognitive remediation in patients with schizophrenia suggest

a positive effect on brain functioning in terms of the functional

reorganisation of neural networks. From a different perspective,

some changes in serum levels of Brain derived neurotrophic factor

(BDNF) have been described. However, our replication of this trial

has not been able to find any significant differences. So, nowadays

the status of BDNF as a biomarker of cognitive recovery is possibly

premature. One possible explanation can be the role of genetics and

their different polymorphisms. COMT and BDNF polymorphisms

could be accounting for the different outcomes of CRT. Moreover,

some studies suggested a role of genes affecting dopamine modu-

lation on outcomes of cognitive remediation.

Disclosure of interest

The author declares that he has no compet-

ing interest.


Impact of Cognitive remediation on

the use of psychiatric services and

patterns of care of patients with


A. Vita

University of Brescia, Clinical and Experimental Sciences, Brescia,


Cognitive remediation (CR) has proved to be effective in improving

cognition, symptoms and psychosocial functioning in schizophre-

nia and other psychoses, but its impact on the use of psychiatric

services and patterns of care of patients suffering from these

diseases is still scarcely known. In fact, it would be particularly rel-

evant to know if such intervention may have any modifying effect

on use of services and costs of treatments. There is preliminary

evidence that such an impact does exist, with possible reduction

of number and duration of hospitalizations and of long-term resi-

dential stays and consequent reduced costs of inpatient treatment.

On the other hand, community treatment costs could be increased

as an effect of a shift of psychiatric and psychosocial interven-

tions from inpatient to outpatient activities. A critical review of

the existing literature on the issue will be provided, together with

a discussion of the impact of this shift towards the attainment of

increased functional and social recovery in the individual patient.

Disclosure of interest

The author declares that he has no compet-

ing interest.