Cognitive remediation training in patients with chronic schizophrenia receiving standardized traditional Chinese medicine as routine care

BACKGROUND Cognitive impairment is the core issue of schizophrenia.Even with antipsychotic medication treatment, this deficiency is often difficult to resolve, highlighting the need for adjunctive nonpharmacological approaches.AIM To investigate whether the addition of cognitive remediation training (CRT) to conventional treatment is associated with improved cognitive function and functional recovery in patients with chronic schizophrenia.METHODS This retrospective cohort study included patients with chronic schizophrenia stably treated at Heilongjiang Mental Hospital from January 2022 to December 2025.Treatment allocation was nonrandomized, and only patients with complete 12-week follow-up data were included.Patients were divided into a CRT plus treatment as usual (TAU) group and a TAU alone group according to whether they completed a 12-week computerized CRT program.Assessments at baseline and 12 weeks included Trail Making Test A (TMT-A), Digit Symbol Coding, Wechsler Memory Scale-Third Edition (WMS-III) Letter-Number Sequencing, Hopkins Verbal Learning Test-Revised (HVLT-R), Positive and Negative Syndrome Scale (PANSS), Personal and Social Performance Scale (PSP), and UCSD Performance-Based Skills Assessment-Brief (UPSA-B).RESULTS A total of 242 patients with comparable baseline characteristics were included (117 CRT + TAU, 125 TAU).At 12 weeks, the CRT + TAU group showed significantly better TMT-A completion time (38.76 ± 7.91 seconds vs 41.33 ± 8.64 seconds, P = 0.017), digit symbol 4 / 40coding (38.76 ± 7.41 vs 36.59 ± 7.68, P = 0.026), WMS-III letter-number sequencing (9.64 ± 2.15 vs 8.93 ± 2.41, P = 0.016), and HVLT-R immediate recall (22.16 ± 4.82 vs 19.37 ± 4.29, adjusted β = 2.92, 95% confidence interval: 1.82-4.02,P < 0.001) than the TAU group did.The CRT + TAU group also had lower PANSS positive (14.82 ± 3.63 vs 16.14 ± 3.92, P = 0.007), negative (19.43 ± 4.55 vs 20.85 ± 4.81, P = 0.019), and general psychopathology (30.62 ± 5.81 vs 33.94 ± 6.12, P < 0.001) scores and higher PSP (56.74 ± 9.63 vs 54.28 ± 9.52, P = 0.047) and UPSA-B (70.46 ± 10.04 vs 67.23 ± 10.82, P = 0.017) scores. CONCLUSIONCRT addition to routine treatment was associated with improvements in cognition, symptoms, and functioning, although cognitive flexibility did not improve.