Cognitive Remediation Therapy for outpatients with chronic schizophrenia:: A controlled and randomized study
Cognitive Remediation Therapy for outpatients with chronic schizophrenia:: A controlled and randomized study
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DOI：
10.1016/j.schres.2006.04.019
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发表时间：
2006-10-01
影响因子：
4.5
通讯作者：
Gasto, Cristobal
中科院分区：
文献类型：
--
作者：
Penades, Rafael;Catalan, Rosa;Gasto, Cristobal
认知矫正疗法（CRT）是一种新颖的康复方法，旨在提高注意力、记忆力和执行功能等神经认知能力。本研究的目的是评估 CRT 对神经认知的影响，其次是对症状和心理社会功能的影响。认知行为疗法（CBT）被用作控制条件，因为它旨在改善情绪问题和阳性症状，重点是改变适应不良的信念和图式，但神经认知不是目标。总共 40 名患有 DSM-IV 精神分裂症的慢性患者被随机分配到两个治疗组之一：CRT 或 CBT，为期 4 个月。在治疗前后以及 6 个月的随访期结束时进行重复评估。此外，我们还根据 20 名精神分裂症患者的单独样本计算出一种确定可靠变化的方法，这些患者接受标准药物治疗，未接受任何心理治疗。结果表明，CRT 全面改善了神经认知（平均效应大小 = 0.5），特别是在语言和非语言记忆以及执行功能方面。 CBT 对一般精神病理学（焦虑和抑郁）显示出预期的治疗效果，但仅对神经认知（工作记忆）产生轻微的非特异性改善。此外，接受 CRT 的患者表现出社会功能的改善，表明认知改善具有临床意义。这些收益在 6 个月的随访中仍然存在。 (c) 2006 Elsevier B.V. 保留所有权利。
Cognitive Remediation Therapy (CRT) is a novel rehabilitation approach designed to improve neurocognitive abilities such as attention, memory and executive functioning. The aim of the present study is to evaluate the effect of CRT on neurocognition, and secondarily on symptomatology and psychosocial functioning. Cognitive Behavioural Therapy (CBT) was used as a control condition because it aims to improve emotional problems and positive symptoms, focusing on modification of maladaptive beliefs and schemas, but neurocognition is not targeted. A total of 40 chronic patients with DSM-IV schizophrenia disorder were randomly assigned for 4 months to one of two treatment groups: CRT or CBT. Repeated assessments were conducted before and after the treatments and at the end of a follow-up period of 6 months. Additionally, a method to establish reliable change was calculated from a separate sample of 20 schizophrenic patients who were under standard medication without any kind of psychological treatment. Results showed that CRT produced an overall improvement on neurocognition (Mean effect size=0.5), particularly in verbal and nonverbal memory, and executive function. CBT showed the expected treatment effect on general psychopathology (anxiety and depression) but produced only a slight non-specific improvement in neurocognition (Working Memory). Furthermore, patients receiving CRT showed improvement in social functioning, demonstrating that cognitive improvements are clinically meaningful. These gains were still present at the 6 month follow-up. (c) 2006 Elsevier B.V. All rights reserved.