A Randomized Controlled Trial of Cognitive Remediation in Schizophrenia
A Randomized Controlled Trial of Cognitive Remediation in Schizophrenia
复制标题
DOI：
10.1093/schbul/sbn102
复制
发表时间：
2010-03-01
影响因子：
6.6
通讯作者：
Harris, Anthony
中科院分区：
文献类型：
--
作者：
Hodge, Marie Antoinette Redoblado;Siciliano, Daniella;Harris, Anthony
人们一直发现精神分裂症患者表现出认知缺陷，这已被确定为心理社会功能结果的关键调节因素。最近对认知补救（CRT）的审查得出的结论是，这些缺陷可以通过训练得到缓解。这项多地点社区研究检查了 40 名精神分裂症患者，他们使用神经心理学教育补救方法 (1) (NEAR) 接受了认知补救。在四个时间点使用相同的神经心理学测试和心理社会结果测量进行评估：基线、主动干预开始前、主动干预结束和主动干预结束后 4 个月。在整个研究期间，抗精神病药物的剂量保持恒定。参加 NEAR 后，个人在语言和视觉记忆、持续注意力和执行功能方面表现出显着改善。这种效果在治疗停止后持续了 4 个月。平均效应大小为轻度至中度。从基线到治疗后，社会和职业结果也有所改善，这种情况在 4 个月后持续存在。我们的研究结果与之前的研究结果一致，即在自然且生态有效的环境中，NEAR 可有效改善精神分裂症患者的认知能力。此外，它还扩展了这些发现，以显示对社会/职业结果的影响的普遍性以及短期影响的持续性。
Individuals with schizophrenia have consistently been found to exhibit cognitive deficits, which have been identified as critical mediators of psychosocial functional outcomes. Recent reviews of cognitive remediation (CRT) have concluded that these deficits respond to training. This multi-site community study examined 40 individuals with schizophrenia who underwent cognitive remediation using the Neuropsychological Educational Approach to Remediation(1) (NEAR). Assessments using the same neuropsychological tests and measures of psychosocial outcome were made at four time points: baseline, before start of active intervention, end of active intervention and 4 months after end of active intervention. Dose of antipsychotic medication remained constant throughout the study period. After participating in NEAR, individuals showed significant improvements in verbal and visual memory, sustained attention and executive functioning. This effect persisted 4 months after the treatment ceased. The average effect size was mild to moderate. Social and occupational outcomes also improved from baseline to post-treatment, which persisted 4 months later. Our findings replicate those of previous studies that suggest that NEAR is effective in improving cognition in individuals with schizophrenia in a naturalistic and ecologically valid setting. Further it extends such findings to show a generalisation of effects to social/occupational outcomes and persistence of effects in the short term.