Should schizophrenia be treated as a neurocognitive disorder?
Should schizophrenia be treated as a neurocognitive disorder?
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DOI：
10.1093/oxfordjournals.schbul.a033380
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发表时间：
1999-01-01
影响因子：
6.6
通讯作者：
Nuechterlein, KH
中科院分区：
文献类型：
--
作者：
Green, MF;Nuechterlein, KH
对精神分裂症神经认知缺陷的有意义的精神药理学和认知/行为干预的研究正在进行中，这一领域的研究结果正在迅速出现，在缺乏整合框架的情况下，它们注定会出现混乱。在这个早期阶段，测试神经认知干预和解释结果的明确指导方针至关重要。在这篇文章中，我们提出了三个日益复杂的模型，试图阐明神经认知缺陷在精神分裂症的治疗和结果方面的作用。通过对模型的讨论，我们将考虑这一研究领域所面临的方法学问题和解释性挑战，包括抗精神病药物的直接与间接神经认知效应，选择特定的神经认知结构进行干预，解释认知/行为研究中结构效度的重要性，以及治疗效果的预期持久性。随着越来越多的人相信精神分裂症的一些神经认知缺陷可以得到改善，几年前似乎无关紧要的问题现在已经成为根本问题。该领域将需要重新考虑什么是成功的干预，相关的结果是什么，以及如何定义治疗效果。
The search is on for meaningful psychopharmacological and cognitive/behavioral interventions for neurocognitive deficits in schizophrenia, Findings in this area are emerging rapidly, and in the absence of integrating frameworks, they are destined to emerge chaotically. Clear guidelines for testing neurocognitive interventions and interpreting results are critical at this early stage. In this article, we present three models of increasing complexity that attempt to elucidate the role of neurocognitive deficits in schizophrenia in relation to treatment and outcome. Through discussion of the models, we will consider methodological issues and interpretive challenges facing this line of investigation, including direct versus indirect neurocognitive effects of antipsychotic medications, selection of particular neurocognitive constructs for intervention, the importance of construct validity in interpreting cognitive/behavioral studies, and the expected durability of treatment effects. With a growing confidence that some neurocognitive deficits in schizophrenia can be modified, questions that seemed irrelevant only a few years ago are now fundamental. The field will need to reconsider what constitutes a successful intervention, what the relevant outcomes are, and how to define treatment efficacy.