Cognitive enhancement therapy for schizophrenia - Effects of a 2-year randomized trial on cognition and behavior
Cognitive enhancement therapy for schizophrenia - Effects of a 2-year randomized trial on cognition and behavior
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DOI：
10.1001/archpsyc.61.9.866
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发表时间：
2004-09-01
影响因子：
--
通讯作者：
Zoretich, R
中科院分区：
文献类型：
--
作者：
Hogarty, GE;Flesher, S;Zoretich, R
背景：社会认知和神经认知缺陷被认为是精神分裂症残疾的基础。康复的尝试对认知的影响有限，在行为和适应的广泛方面没有同时改善。目的：比较认知增强疗法（一种恢复期干预）与最先进的强化支持疗法对认知和行为的不同影响。设计：一项为期2年的随机对照试验，在基线、12个月和24个月时完成神经心理学和行为评估。环境：位于某医疗中心重症精神疾病患者综合护理服务中心的门诊研究诊所。患者：共121例症状稳定、非药物滥用但认知障碍和患有精神分裂症或分裂情感性障碍的慢性疾病患者。干预措施：认知增强疗法是一种多维的、发展性的方法，它将计算机辅助的神经认知训练与社会认知小组练习相结合。丰富的支持性治疗通过应用应对策略和教育促进疾病管理。主要观察指标：采用协方差分析和线性趋势分析对加工速度、神经认知、认知风格、社会认知、社会适应和症状六个高可靠的综合指标进行检验。结果：在12个月时，认知增强治疗对神经认知和处理速度复合材料的影响显著(P
Background: Deficits in social cognition and neurocognition are believed to underlie schizophrenia disability. Attempts at rehabilitation have had circumscribed effects on cognition, without concurrent improvement in broad aspects of behavior and adjustment.objective: To determine the differential effects of cognitive enhancement therapy (a recovery-phase intervention) on cognition and behavior compared with state-of-the-art enriched supportive therapy.Design: A 2-year, randomized controlled trial with neuropsychological and behavioral assessments completed at baseline and at 12 and 24 months. Setting: An outpatient research clinic housed in a medical center's comprehensive care service for patients with severe mental illness.Patients: A total of 121 symptomatically stable, nonsubstance-abusing but cognitively disabled and chronically ill patients with schizophrenia or schizoaffective disorder.Interventions: Cognitive enhancement therapy is a multidimensional, developmental approach that integrates computer-assisted training in neurocognition with social cognitive group exercises. Enriched supportive therapy fosters illness management through applied coping strategies and education.Main Outcome Measures: Six highly reliable summary measures-Processing Speed, Neurocognition, Cognitive Style, Social Cognition, Social Adjustment and Symptoms-were tested using analysis of covariance and linear trend analysis.Results: At 12 months, robust cognitive enhancement therapy effects were observed on the Neurocognition and Processing Speed composites (P