Effects of cognitive treatment in psychiatric rehabilitation.
Effects of cognitive treatment in psychiatric rehabilitation.
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DOI：
10.1093/oxfordjournals.schbul.a033409
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发表时间：
1999
影响因子：
6.6
通讯作者：
W. Spaulding;D. Reed;M. Sullivan;Charles E. Richardson;M. Weiler
中科院分区：
文献类型：
--
作者：
W. Spaulding;D. Reed;M. Sullivan;Charles E. Richardson;M. Weiler
90 名患有严重和致残精神疾病（主要是精神分裂症）的受试者参加了综合心理治疗 (IPT) 认知部分的对照结果试验，这是一种旨在重建基本神经认知功能的团体治疗方式。在为期 6 个月的强化治疗期间，对实验条件下的受试者进行认知治疗。对照受试者接受支持性团体治疗。在强化治疗之前、期间和之后，所有受试者都接受了丰富的综合精神康复方案，包括社交和生活技能训练、最佳药物治疗、职业治疗和基于环境的行为治疗。与主要结果指标（人际问题解决能力评估）相比，IPT 受试者表现出更大的收益，这表明针对精神分裂症谱系障碍认知障碍的程序可以增强患者对标准精神康复的反应，至少在短期内，在社交能力领域。有模棱两可的证据表明，简明精神病评定量表混乱因素的实验条件有更大的改善，而有力的证据表明，注意力处理的实验室测量有更大的改善。这两种情况在注意力、记忆力和执行功能方面都有显着改善，这为以下假设提供了支持：针对认知受损的治疗程序在 6 个月的时间范围内增强了对传统精神康复模式的反应。
Ninety subjects with severe and disabling psychiatric conditions, predominantly schizophrenia, participated in a controlled-outcome trial of the cognitive component of Integrated Psychological Therapy (IPT), a group-therapy modality intended to reestablish basic neurocognitive functions. The cognitive therapy was delivered to subjects in the experimental condition during intensive 6-month treatment periods. Control subjects received supportive group therapy. Before, during, and after the intensive treatment period, all subjects received an enriched regimen of comprehensive psychiatric rehabilitation, including social and living skills training, optimal pharmacotherapy, occupational therapy, and milieu-based behavioral treatment. IPT subjects showed incrementally greater gains compared with controls on the primary outcome measure, the Assessment of Interpersonal Problem-Solving Skills, suggesting that procedures that target cognitive impairments of schizophrenia spectrum disorders can enhance patients' response to standard psychiatric rehabilitation, at least in the short term, in the domain of social competence. There was equivocal evidence for greater improvement in the experimental condition on the Brief Psychiatric Rating Scale disorganization factor and strong evidence for greater improvement on a laboratory measure of attentional processing. There was significant improvement in both conditions on measures of attention, memory, and executive functioning, providing support for the hypothesis that therapeutic procedures that target impaired cognition enhance response to conventional psychiatric rehabilitation modalities over a 6-month timeframe.