Quels programmes de remédiation cognitive pour le premier épisode psychotique ?

Cognitive remediation is efficient to treat cognitive disorders associated with schizophrenia. Since (i) these disorders play a negative role in functional outcome and (ii) antipsychotics do not improve significantly cognition, cognitive remediation should be systematically used with patients with schizophrenia and after the first episode of psychosis. A comprehensive neuropsychological assessment, that precedes the beginning of cognitive remediation, allows targeting the most impaired cognitive domains. Cognitive remediation intervention takes place after symptoms stabilization. It needs also that the antipsychotic treatment was prescribed at minimal fully effective dose and that the patients have acquired a minimal understanding of their disease (i.e. after psychoeducation). Cognitive remediation programs that have been validated for schizophrenia (NEAR, CET, NET, IPT, CRT…) can be used after the first episode of psychosis.