Aims Alcohol use disorder (AUD) is associated with deficits in various cognitive functions which can impair conventional treatment and increase relapse risk. This longitudinal quasi-randomized controlled study investigated chess-based cognitive remediation training (CB-CRT) as add-on therapy to improve cognitive control and psychosocial outcomes compared to standard rehabilitation.

Materials and methods The study was conducted from April 2022 to November 2023 among AUD patients in long-term residential rehabilitation. Participants in the experimental group attended 90-minute CB-CRT group sessions twice weekly for six weeks between April 2022 and April 2023, conducted by clinical staff using the „Entrenamiento cognitivo a través del ajedrez” (ECAM®) method. Assessments were conducted at baseline (T1, day 1), post-intervention (T2, day 42), and on day 126 (T3). Primary outcomes were training effects in sustained attention, decision-making, and set shifting (cognitive flexibility). Abstinence, craving, subjective well-being, and liking of the intervention were assessed at all timepoints (T1, T2, and T3).

Results Fifty-one participants completed two timepoints (T2 six weeks after T1): n = 32 allocated to the experimental group and n = 19 to the control group (no chess intervention). The CB-CRT group showed significant improvement in sustained attention (MDiff = 8.26) and a positive, non-significant trend in cognitive flexibility at T2. No significant effects were found for short-term abstinence, craving, or mood at T3 (day 126). A significant increase in general life satisfaction was observed in the CB-CRT group at T2 (MDiff = 3.78), though not sustained at follow-up. The intervention was well accepted, with increased recommendation scores between T1 and later assessments.

Conclusions CB-CRT improved sustained attention and general life satisfaction, and was well accepted. However, the relatively small sample size limited statistical power and detection of further effects. A larger replication study could enhance generalizability and clarify impacts on cognitive control, relapse, and relapse timing.

The authors have declared no competing interest.

NCT04057534

https://bmjopen.bmj.com/content/bmjopen/12/9/e057707.full.pdf?fbclid=IwAR0x-fQvhG8X1s7nChH6Q0fNYPrm6EKP0eH3Q55C-XMdtcnSE9Wm535DB5s

This study was supported by a grant from the Deutsche Forschungsgemeinschaft (Project ID 421888313). The Deutsche Forschungsgemeinschaft was not involved in the planning of the study, in data collection, analyses or publication procedures.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

This study was embedded in the clinical fMRI trial for alcohol as well as tobacco use disorder. The trial has been approved by the Ethics Committee of the Medical Faculty Mannheim at the University of Heidelberg (reference number 2017-647N-MA). Before study inclusion and after a detailed explanation of all procedures, all participants have given written informed consent.

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The data that support the findings of this study are available from the corresponding author upon reasonable request.