Cognitive remediation for schizophrenia: it is even more complicated
Cognitive remediation for schizophrenia: it is even more complicated
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精神分裂症的认知治疗：更复杂
DOI：
10.1097/yco.0b013e328322fbf4
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发表时间：
2009
影响因子：
6.9
通讯作者：
V. Huddy
中科院分区：
文献类型：
--
作者：
T. Wykes;V. Huddy
试图纠正精神分裂症患者的认知困难已显示出疗效；然而，现有的治疗研究显示出巨大的差异，令人沮丧的努力，以确定如何最好地应用这种治疗工具。本文综述了精神分裂症诱导的认知改变的研究成果，包括补救方法、伴随治疗的存在、认知改变如何普遍化及其价值。尽管有强有力的证据表明，精神分裂症患者的认知改变可以被诱导，但几乎没有证据表明任何治疗方法都具有优势。此外，补救措施与其他治疗方法（如职业培训）结合使用时最为有效。认知康复具有成本效益，受到患者的重视。许多研究表明，积极结果的泛化超越了认知变量，更集中的治疗与更少的泛化相关。诱导的认知变化并不一定需要很大才能促进功能结果。相反，在现实世界中应用新获得的认知技能和策略的机会至关重要。下一代的研究需要比较不同的治疗方法，使用特定的和更一般的认知结果测量方法。这些可能会揭示它们的作用机制。这些更复杂的研究结果将允许治疗师为个体量身定制治疗方法，以最大限度地为患者带来好处。
Purpose of review Attempts to remediate the cognitive difficulties of people with a diagnosis of schizophrenia have shown efficacy; however, existing treatment studies display huge variation, frustrating efforts to determine how best to apply this treatment tool. This review summarizes findings of induced cognitive change in schizophrenia, with reference to the remediation method, the presence of accompanying treatment(s), how cognitive change generalizes and its value. Recent findings Although there is strong evidence that cognitive change can be induced in schizophrenia, there is little evidence for the superiority of any treatment approach. Furthermore, remediation is most effective when in combination with other treatments, such as vocational training. Cognitive rehabilitation can be cost-effective and is valued by patients. A number of studies show generalization of positive outcomes beyond cognitive variables, with more focused treatment associated with less generalization. Summary Induced cognitive change does not necessarily need to be large to facilitate functional outcomes. Instead, opportunities to apply newly acquired cognitive skills and strategies in the real world are vital. The next generation of studies need to compare different treatments using specific and more general measures of cognitive outcome. These may then throw light on their mechanisms of action. The results of these more sophisticated studies will allow therapists to tailor treatments to individuals to maximize gain for patients.
影响因子：
--
作者：
Keefe, Richard S. E.;Bilder, Robert M.;Lieberman, Jcffrey A.
通讯作者：
Lieberman, Jcffrey A.
影响因子：
--
作者：
Cannon, M;Caspi, A;Poulton, R
通讯作者：
Poulton, R