Cognitive remediation in schizophrenia: efficacy and effectiveness in patients with early versus long-term course of illness
Cognitive remediation in schizophrenia: efficacy and effectiveness in patients with early versus long-term course of illness
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DOI：
10.1111/eip.12029
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发表时间：
2014-02-01
影响因子：
2
通讯作者：
Harvey, Philip D.
中科院分区：
文献类型：
--
作者：
Bowie, Christopher R.;Grossman, Michael;Harvey, Philip D.
目的：我们研究的疗效和有效性（转移到功能能力和日常运作）的认知补救早期课程（5年内首次发病）和长期（超过15年的疾病）schizophrenia.Methods：治疗持续了12周，包括计算机化的练习，战略监测和方法，认知行为转移。评估包括一个标准电池的神经认知，基于性能的措施，社会和适应能力，并在现实世界中的功能行为的情况下经理评级。从基线到治疗后的变化进行了检查，重复测量方差分析和估计发病前的智能和总月在医院作为covariates.Results：早期课程组有较大的改善措施的处理速度和执行功能，以及较大的改善，在适应能力和现实世界的工作技能。疾病的持续时间与神经认知和现实世界的工作skills.Conclusions的改善呈负相关：认知障碍的治疗是可行的，在早期和慢性精神分裂症，但临床意义和泛化功能似乎是更大的早期交付时。认知补救应被视为精神分裂症早期干预的工具。
Aim: We examined the efficacy and effectiveness (transfer to functional competence and everyday functioning) of cognitive remediation in early-course (within 5 years of first episode) and long-term (more than 15 years of illness) schizophrenia.Methods: Treatment lasted 12 weeks and included computerized exercises, strategic monitoring and methods to transfer cognition to behaviour. Assessments included a standard battery of neurocognition, performance-based measures of social and adaptive competence, and case manager ratings of real-world functional behaviour. Changes from baseline to post-treatment were examined with repeated measures analysis of variance and estimated premorbid intelligence and total months in hospital as covariates.Results: The early-course group had larger improvements in measures of processing speed and executive functions, as well as larger improvements in adaptive competence and real-world work skills. Duration of illness was inversely associated with improvement in neurocognition and real-world work skills.Conclusions: Treatment of cognitive impairments is feasible in both early-course and chronic schizophrenia, but the clinical meaningfulness and generalization to functioning appear to be more substantial when delivered early. Cognitive remediation should be considered a tool for early intervention in schizophrenia.