Cognitive impairment is a central feature of schizophrenia and has shown to play a crucial role in the psychosocial function of the disorder. Over the past few years, several cognitive remediation (CR) interventions have been developed for schizophrenia, whose effectiveness has also been widely demonstrated by systematic reviews and meta-analysis studies. Despite these evidences, many questions remain open. In particular, the identification of CR response predictors in patients with schizophrenia is still a topic with equivocal findings and only a few studies have looked for the relationship between CR response or resistance and the biological, socio-demographic, clinical and cognitive features in schizophrenia. The current knowledge on positive or negative response predictors to CR treatment in schizophrenia include: age, duration of illness, premorbid adjustment, baseline cognitive performance, intrinsic motivation, hostility, disorganized symptoms, neurobiological reserve, genetic polymorphisms, the amounts of antipsychotics, the type of CR, etc. The aim of this review is to identify neurobiological, psychopathological, cognitive, and functional predictors of CR response or resistance in schizophrenia, taking into account both cognitive and functional outcome measures. The information obtained could be very useful in planning integrated and personalized interventions, also with a better use of the available resources.

Background: Cognitive impairment represents a central component of major depressive disorder (MDD), affecting a large proportion of people living with MDD and showing a consistent negative impact on social, interpersonal, and occupational functioning and subjective quality of life. Cognitive remediation (CR) is a training-based psychosocial intervention targeting cognitive performance and psychosocial functioning that has shown consistent evidence of effectiveness in individuals with schizophrenia and that could provide significant benefits also in people with MDD: this study aimed to assess the effects of a computerized CR intervention in adults living with MDD. Methods: Participants recruited in this single blind multicentric randomized controlled trial were allocated to receive a computerized CR intervention delivered by an active and trained therapist or to an active control condition (computer games – CG). Outcomes were measured with validated instruments by blind assessors and included cognitive performance, depressive symptoms, and psychosocial functioning. Outcomes were assessed using mixed models for repeated measures, considering baseline and end-of-treatment scores. Results: Hundred and one participants (CR=52 and CG=49) were included and 81 (CR=45 and CG=36) completed the study. CR produced superior results in clinician-rated depressive symptoms (p=0.023, d=042), global clinical severity (p=0.025, d=0.39), subjective depressive symptoms (p=0.005, d=0.45), working memory performance (p=0.004, d=0.34), executive functions/cognitive flexibility (p=0.020, d=0.43), and subjective cognitive impairment (p=0.006, d=0.48). Conclusions: CR represents an effective intervention in MDD, improving clinical outcomes and cognitive performance in a clinician-rated and in a subjective manner, which should be more consistently implemented in clinical practice and included in MDD treatment recommendations.

Background: COVID-19 has limited pregnant and postpartum women’s access to mental health services, leading to the introduction of online interventions. Objectives: This study aims to compare the effectiveness of telepsychotherapy (i.e., psychotherapy provided through digital technology supporting real-time interactivity in the audio or audiovisual modality) with the one yielded by face-to-face interventions in treating perinatal depression and anxiety and to assess the therapist’s perceived alliance in both interventions. Methods: We collected anamnestic information and obstetrical risk factors for 61 women. We evaluated the effectiveness of face-to-face (N = 31) vs. telepsychotherapy (N = 30) interventions on depressive and anxiety symptoms at baseline (T0) and the end of treatment (T1) using the Edinburgh Postnatal Depression Scale (EPDS) and the State-Trait Anxiety Inventory (STAI-Y 1 and 2). We assessed the degree of alliance perceived by therapists with the Working Alliance Inventory (WAI-T). Results: Both groups showed significant decreases in depressive (EPDS face-to-face: T0 12.65 ± 5.81, T1 5.77 ± 4.63, p < 0.001; EPDS remote: T0 11.93 ± 5.24, T1 5.70 ± 4.46, p < 0.001; effect size: 0.002) and state anxiety (STAI-Y 1 face-to-face: T0 51.19 ± 13.73, T1 40.23 ± 12.86, p < 0.001; STAI-Y 1 remote: T0 51.10 ± 11.29, T1 38.00 ± 10.90, p < 0.001; effect size: 0.007//STAI-Y 2 face-to-face: T0 43.13 ± 12.11, T1 41.03 ± 13.06, p = 0.302; STAI-Y 2 remote: T0 44.20 ± 8.70, T1 39.30 ± 9.58, p = 0.003; effect size: <0.001) symptoms by the end of treatment. Women treated remotely also experienced a significant reduction in trait anxiety at T1 (p = 0.003). We found no significant differences in either symptomatology (EPDS; STAI-Y) between the two interventions at baseline or in the therapist-perceived alliance. Conclusions: Synchronous telepsychotherapy for perinatal depression and anxiety showed comparable treatment response to face-to-face interventions, with both modalities associated with significant symptom reduction and the establishment of a working alliance. These findings support the potential of telepsychotherapy as a valuable alternative when in-person services are not accessible, especially during emergency contexts.