Evidence map›Paper›PMID 30654644›Full record

Trial reportThe American journal of psychiatry2019

Guanfacine Augmentation of a Combined Intervention of Computerized Cognitive Remediation Therapy and Social Skills Training for Schizotypal Personality Disorder.

Margaret M McClure, Fiona Graff, Joseph Triebwasser, Mercedes Perez-Rodriguez, Daniel R Rosell, Harold Koenigsberg, Erin A Hazlett, Larry J Siever, Philip D Harvey, Antonia S New

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The American journal of psychiatry, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
3.1field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 34 citations in OpenAlex.

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  10. An NIMH Workshop on Non-Affective Psychosis in Midlife and Beyond: Research Agenda on Phenomenology, Clinical Trajectories, Underlying Mechanisms, and Intervention Targets.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2023
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Margaret M McClureDepartment of Psychiatry, Mt. Sinai School of Medicine, New York (McClure, Perez-Rodriguez, Rosell, Koenigsberg, Hazlett, Siever, New); Department of Psychology, Fairfield University, Fairfield, Conn. (McClure); War Related Illness and Injury Study Center, VA New Jersey Health Care System, East Orange (Graff); Department of Veterans Affairs, VISN2 Mental Illness Research, Education, and Clinical Center, Bronx, N.Y. (Triebwasser, Koenigsberg, Hazlett, Siever); Department of Psychiatry, University of Miami Miller School of Medicine, Miami (Harvey).
Fiona GraffDepartment of Psychiatry, Mt. Sinai School of Medicine, New York (McClure, Perez-Rodriguez, Rosell, Koenigsberg, Hazlett, Siever, New); Department of Psychology, Fairfield University, Fairfield, Conn. (McClure); War Related Illness and Injury Study Center, VA New Jersey Health Care System, East Orange (Graff); Department of Veterans Affairs, VISN2 Mental Illness Research, Education, and Clinical Center, Bronx, N.Y. (Triebwasser, Koenigsberg, Hazlett, Siever); Department of Psychiatry, University of Miami Miller School of Medicine, Miami (Harvey).
Joseph TriebwasserDepartment of Psychiatry, Mt. Sinai School of Medicine, New York (McClure, Perez-Rodriguez, Rosell, Koenigsberg, Hazlett, Siever, New); Department of Psychology, Fairfield University, Fairfield, Conn. (McClure); War Related Illness and Injury Study Center, VA New Jersey Health Care System, East Orange (Graff); Department of Veterans Affairs, VISN2 Mental Illness Research, Education, and Clinical Center, Bronx, N.Y. (Triebwasser, Koenigsberg, Hazlett, Siever); Department of Psychiatry, University of Miami Miller School of Medicine, Miami (Harvey).
Mercedes Perez-RodriguezDepartment of Psychiatry, Mt. Sinai School of Medicine, New York (McClure, Perez-Rodriguez, Rosell, Koenigsberg, Hazlett, Siever, New); Department of Psychology, Fairfield University, Fairfield, Conn. (McClure); War Related Illness and Injury Study Center, VA New Jersey Health Care System, East Orange (Graff); Department of Veterans Affairs, VISN2 Mental Illness Research, Education, and Clinical Center, Bronx, N.Y. (Triebwasser, Koenigsberg, Hazlett, Siever); Department of Psychiatry, University of Miami Miller School of Medicine, Miami (Harvey).
Daniel R RosellDepartment of Psychiatry, Mt. Sinai School of Medicine, New York (McClure, Perez-Rodriguez, Rosell, Koenigsberg, Hazlett, Siever, New); Department of Psychology, Fairfield University, Fairfield, Conn. (McClure); War Related Illness and Injury Study Center, VA New Jersey Health Care System, East Orange (Graff); Department of Veterans Affairs, VISN2 Mental Illness Research, Education, and Clinical Center, Bronx, N.Y. (Triebwasser, Koenigsberg, Hazlett, Siever); Department of Psychiatry, University of Miami Miller School of Medicine, Miami (Harvey).
Harold KoenigsbergDepartment of Psychiatry, Mt. Sinai School of Medicine, New York (McClure, Perez-Rodriguez, Rosell, Koenigsberg, Hazlett, Siever, New); Department of Psychology, Fairfield University, Fairfield, Conn. (McClure); War Related Illness and Injury Study Center, VA New Jersey Health Care System, East Orange (Graff); Department of Veterans Affairs, VISN2 Mental Illness Research, Education, and Clinical Center, Bronx, N.Y. (Triebwasser, Koenigsberg, Hazlett, Siever); Department of Psychiatry, University of Miami Miller School of Medicine, Miami (Harvey).
Erin A HazlettDepartment of Psychiatry, Mt. Sinai School of Medicine, New York (McClure, Perez-Rodriguez, Rosell, Koenigsberg, Hazlett, Siever, New); Department of Psychology, Fairfield University, Fairfield, Conn. (McClure); War Related Illness and Injury Study Center, VA New Jersey Health Care System, East Orange (Graff); Department of Veterans Affairs, VISN2 Mental Illness Research, Education, and Clinical Center, Bronx, N.Y. (Triebwasser, Koenigsberg, Hazlett, Siever); Department of Psychiatry, University of Miami Miller School of Medicine, Miami (Harvey).
Larry J SieverDepartment of Psychiatry, Mt. Sinai School of Medicine, New York (McClure, Perez-Rodriguez, Rosell, Koenigsberg, Hazlett, Siever, New); Department of Psychology, Fairfield University, Fairfield, Conn. (McClure); War Related Illness and Injury Study Center, VA New Jersey Health Care System, East Orange (Graff); Department of Veterans Affairs, VISN2 Mental Illness Research, Education, and Clinical Center, Bronx, N.Y. (Triebwasser, Koenigsberg, Hazlett, Siever); Department of Psychiatry, University of Miami Miller School of Medicine, Miami (Harvey).
Philip D HarveyDepartment of Psychiatry, Mt. Sinai School of Medicine, New York (McClure, Perez-Rodriguez, Rosell, Koenigsberg, Hazlett, Siever, New); Department of Psychology, Fairfield University, Fairfield, Conn. (McClure); War Related Illness and Injury Study Center, VA New Jersey Health Care System, East Orange (Graff); Department of Veterans Affairs, VISN2 Mental Illness Research, Education, and Clinical Center, Bronx, N.Y. (Triebwasser, Koenigsberg, Hazlett, Siever); Department of Psychiatry, University of Miami Miller School of Medicine, Miami (Harvey).
Antonia S NewDepartment of Psychiatry, Mt. Sinai School of Medicine, New York (McClure, Perez-Rodriguez, Rosell, Koenigsberg, Hazlett, Siever, New); Department of Psychology, Fairfield University, Fairfield, Conn. (McClure); War Related Illness and Injury Study Center, VA New Jersey Health Care System, East Orange (Graff); Department of Veterans Affairs, VISN2 Mental Illness Research, Education, and Clinical Center, Bronx, N.Y. (Triebwasser, Koenigsberg, Hazlett, Siever); Department of Psychiatry, University of Miami Miller School of Medicine, Miami (Harvey).
VA New Jersey Health Care System · US

Funding

A D1 Agonist for Working Memory Enhancement in the Schizophrenia SpectrumR01MH097799 · NIMH · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI NEW, ANTONIA S · 2013 to 2017
$2.5M
Neurobiology of Affective Instability in Veterans at Low and High Risk for SuicideI01CX001451 · VA · JAMES J PETERS VA MEDICAL CENTER · PI HAZLETT, ERIN A. · 2017 to 2021
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CSR&D Research Career Scientist Award ApplicationIK6CX001738 · VA · JAMES J PETERS VA MEDICAL CENTER · PI HAZLETT, ERIN A. · 2018 to 2022
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CSRD VA I01 CX001451CSRD VA IK6 CX001738NIMH NIH HHS R01 MH097799
6 · The paper itself

Abstract

objectiveImpaired cognition is a hallmark of schizophrenia spectrum disorders, including schizotypal personality disorder, and it is the best predictor of functional outcome. Cognitive remediation therapy has demonstrated efficacy for improving cognition, augmenting other rehabilitation efforts in schizophrenia, and effecting gains in real-world functioning. Pharmacological augmentation of cognitive remediation has been attempted, but the effects of augmentation on combined therapies, such as cognitive remediation and social skills training, have not been studied.

methodsTwenty-eight participants with schizotypal personality disorder enrolled in an 8-week, randomized, double-blind, placebo-controlled trial of guanfacine plus cognitive remediation and social skills training (15 guanfacine, 13 placebo). Cognition was assessed with the MATRICS (Measurement and Treatment Research to Improve Cognition in Schizophrenia) Consensus Cognitive Battery (MCCB), social cognition with the Movie for the Assessment of Social Cognition (MASC), and functional capacity with the University of California San Diego Performance-Based Skills Assessment (UPSA).

resultsA statistically significant pre- versus posttreatment effect was observed for MCCB speed of processing, verbal learning, and visual learning and UPSA total score. A significant time-by-medication (guanfacine, placebo) interaction was observed for MCCB reasoning and problem solving and UPSA total score; the time-by-treatment interaction approached significance for MASC hypomentalizing errors.

conclusionsBoth guanfacine and cognitive remediation plus social skills training were well tolerated, with no side effects or dropouts. Participants treated with cognitive remediation, social skills training, and guanfacine demonstrated statistically significant improvements in reasoning and problem solving, as well as in functional capacity and possibly social cognition, compared with those treated with cognitive remediation, social skills training, and placebo. Cognitive remediation plus social skills training may be an appropriate intervention for individuals with schizotypal personality disorder, and guanfacine appears to be a promising pharmaceutical augmentation to this psychosocial intervention.

Indexed as

Social SkillsAdrenergic alpha-2 Receptor AgonistsAdultCognitive RemediationCombined Modality TherapyDouble-Blind MethodFemaleGuanfacineHumansMaleMiddle AgedNeuropsychological TestsSchizotypal Personality DisorderAdrenergic alpha-2 Receptor AgonistsGuanfacineCognitionCognitive Remediation TherapyGuanfacinePersonality Disorders-Cluster A (Paranoid-Schizoid-Schizotypal)Schizophrenia

Identifiers

PMID30654644
PMCPMC6443471
OpenAlexW2909163604

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.