Bellack A S
Medical College of Pennsylvania-EPPI, Philadelphia 19129.
Schizophr Bull. 1992;18(1):43-50. doi: 10.1093/schbul/18.1.43.
Limitations of available psychosocial interventions combined with the increasing evidence that schizophrenia is characterized by diverse deficits in information processing has stimulated great interest in the possibility of cognitive rehabilitation. However, the current optimism seems unjustified. The precise role of information processing in the behavioral handicaps evidenced by schizophrenic patients is not clear, and the neuropsychologic and experimental psychopathology tasks used to assess information processing generally cannot specify precisely which cognitive functions are deficient. Thus, the choice of cognitive targets for rehabilitation is arbitrary. The strategies currently employed for rehabilitation emphasize an exercise model of treatment and the use of complex mnemonics. Neither approach has been successful in rehabilitating brain-injured patients, and preliminary results with schizophrenic patients are not very promising. It is concluded that the field might be better served by focusing on environmental change and compensatory strategies until we determine how and why schizophrenic patients fail.
现有心理社会干预措施的局限性，再加上越来越多的证据表明精神分裂症的特征是信息处理存在多种缺陷，这激发了人们对认知康复可能性的极大兴趣。然而，目前的乐观态度似乎没有依据。信息处理在精神分裂症患者所表现出的行为障碍中的确切作用尚不清楚，而且用于评估信息处理的神经心理学和实验性精神病理学任务通常无法精确确定哪些认知功能存在缺陷。因此，康复认知目标的选择具有随意性。目前用于康复的策略强调治疗的练习模式和使用复杂的记忆方法。这两种方法在脑损伤患者的康复中都未取得成功，对精神分裂症患者的初步治疗结果也不太乐观。得出的结论是，在我们确定精神分裂症患者失败的方式和原因之前，关注环境变化和代偿策略可能会为该领域带来更好的效果。
