Cognitive remediation for adults with schizophrenia: Does age matter?
Cognitive remediation for adults with schizophrenia: Does age matter?
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DOI：
10.1016/j.psychres.2016.10.084
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发表时间：
2017-01-01
影响因子：
11.3
通讯作者：
Kurtz, Matthew M.
中科院分区：
文献类型：
--
作者：
Corbera, Silvia;Wexler, Bruce E.;Kurtz, Matthew M.
认知补救（CR）是一种新的行为干预，旨在通过重复的任务练习和/或策略获得来改善认知缺陷，在精神分裂症患者中获得了越来越多的经验支持，但治疗反应仍存在显著的个体差异（Wykes等人，2011年）。年龄对精神分裂症患者CR反应的作用仍有待研究。我们在一项盲法随机对照试验（RCT）中评估了三个年龄范围在CR治疗反应中相对于紧密匹配的计算机技能控制干预的作用，该试验将112名精神分裂症成年患者分为三组：早期组，（ES; 25岁或以下，平均=3.4年的疾病; n=45），早期慢性组（EC; 26-39，平均=7.6年的疾病; n=31）和晚期慢性组（LC; 40岁及以上，平均=18.2年的疾病; n=36）。在认知结果方面，早期和早期慢性精神分裂症患者在工作记忆测量的趋势水平上对CR的反应有更大的改善，相对于晚期慢性客户。这些发现在对接受足够剂量治疗的客户进行的子样本分析中得到了证实。这些研究结果强调，需要调整现有的CR方案，以更有效地满足老年客户群体的需求。
Cognitive remediation (CR), a novel behavioral intervention designed to improve cognitive deficits through repeated task practice and/or strategy acquisition has gained increasing empirical support in people with schizophrenia, but substantial individual differences in treatment response remain (Wykes et al., 2011). The role of age on response to CR in schizophrenia remains understudied. We evaluated the role of three age ranges in treatment response to CR relative to a closely-matched computer skills control intervention in a blinded, randomized control trial (RCT) with 112 adults with schizophrenia divided into three groups: an early-stage group (ES; 25 years or younger, mean=3.4 years of illness; n=45), an early-chronic group (EC; 26-39, mean=7.6 years of illness; n=31) and a late-chronic group (LC; 40 and over, mean=18.2 years of illness; n=36). With respect to cognitive outcomes, early-stage and early-chronic individuals with schizophrenia showed greater improvement in response to CR on a working memory measure at a trend level, relative to late-chronic clients. These findings were confirmed in analyses of a subsample of clients who received an adequate dose of treatment. These findings emphasize the need for adaptations of currently-existing CR programs to more effectively address the needs of older client populations.