Treatment Response to Rehabilitation in Schizophrenia

我们提出了一项前瞻性研究，调查精神分裂症患者的症状和神经认知功能障碍与综合康复计划治疗反应的关系。研究1将调查的关系，症状和神经认知变量测量在程序进入到两年后测量的心理社会和职业地位。研究2将调查症状和神经认知变量的关系，在程序进入治疗反应的患者分配到认知补救轨道或计算机技能训练轨道作为其康复治疗的一部分。对于研究1，预测在进入康复计划时测量的在解决问题、言语记忆和/或视觉警觉方面具有神经认知障碍的患者相对于没有这些障碍的患者在一年后测量的心理社会和就业结果将显示较差。对于研究2，预计在进入康复计划时测量的神经认知障碍将与康复治疗的特定组成部分相关。我们假设：A。与接受计算机技能培训治疗的患者相比，接受认知补救治疗的患者在解决问题、言语记忆和/或视觉警觉方面表现出受损，在心理社会和就业状况方面表现出更大的改善。B）相对于接受认知补救治疗的患者，在这些神经认知方面表现出轻微损害的患者在接受计算机技能培训治疗时，将表现出心理社会和就业状况的更大改善。这项研究将提供新的信息：（1）神经认知和症状之间的关系，以治疗后的结果，从而确定需要解决的患者特征，以改善治疗反应;（2）神经认知和症状与强化康复治疗计划特定要素治疗后结果的关系，从而为患者与特定行为治疗的匹配提供经验基础。

We propose a prospective study to investigate the relationship of symptoms and neurocognitive impairment to treatment response to a comprehensive rehabilitation program for patients with schizophrenia. Study 1 will investigate the relationship of symptoms and neurocognitive variables measured at program entry to psychosocial and vocational status measured two years later. Study 2 will investigate the relationship of symptoms and neurocognitive variables measured at program entry to treatment response for patients assigned to either a cognitive remediation track or a computer skills training track as part of their rehabilitation treatment. For Study 1 it is predicted that patients with neurocognitive impairment in problem-solving, verbal memory and/or visual vigilance measured at entry to a rehabilitation program will show poorer psychosocial and employment outcome measured one-year later, relative to patients without these impairments. For Study 2, it is predicted that neurocognitive impairment measured at entry to the rehabilitation program will be related to specific components of rehabilitation treatments. We hypothesize that: a. Those patients showing impairment in problem-solving, verbal memory and/or visual vigilance, will show greater improvement in psychosocial and employment status when treated with cognitive remediation relative to patients treated with computer skills training. b) Those patients showing little impairment in these aspects of neurocognition will show greater improvement in psychosocial and employment status when treated with computer skills training, relative to patients treated with cognitive remediation. The study will provide new information regarding: (1) relationships between neurocognition and symptoms to outcome after treatment, thereby identifying patient features that need to be addressed to improve treatment response; (2) relationships of neurocognition and symptoms to outcome after treatment with specific elements of an intensive rehabilitation treatment program, thereby providing an empirical basis for matching of patients to specific behavioral treatments.