Bell Morris D, Fiszdon Joanna, Bryson Gary, Wexler Bruce E
Psychology Service, VA Connecticut Healthcare System, West Haven 06516, USA.
Cogn Neuropsychiatry. 2004 Aug;9(3):199-211. doi: 10.1080/13546800344000084.
A preponderance of research indicates that cognitive function in schizophrenia can be improved through cognitive remediation. However, few studies have attempted to characterise the extent of improvement relative to nonpsychiatric controls.
Cognitive performance on reaction time, digit recall, and word recall of 58 schizophrenia patients at baseline and after 6 months of cognitive remediation was compared to the performance on these tasks of 39 community controls. Schizophrenia patients participated in Neurocognitive Enhancement Therapy (NET) and received hierarchical training on the memory tasks, but not on the reaction time task, which was only administered at intake and follow-up.
The schizophrenia sample showed significantly poorer performances than the community control sample on all three tasks at baseline. NET led to significant improvements in performance on trained memory tasks, but not the untrained reaction time task. There was a significant increase in the proportion of schizophrenia patients who achieved normal range performance on the memory tasks.
52% of schizophrenia patients who were impaired on at least one of the memory tasks normalised their performance on at least one of those tasks as a result of cognitive training. Results suggest that clinically meaningful improvement may be possible using cognitive remediation.
大量研究表明,通过认知矫正可以改善精神分裂症患者的认知功能。然而,很少有研究试图描述相对于非精神科对照人群而言改善的程度。
将58例精神分裂症患者在基线时以及经过6个月认知矫正后的反应时间、数字回忆和单词回忆方面的认知表现,与39名社区对照人群在这些任务上的表现进行比较。精神分裂症患者参加了神经认知增强疗法(NET),并在记忆任务上接受了分层训练,但反应时间任务未进行训练,该任务仅在入组时和随访时进行。
在基线时,精神分裂症样本在所有三项任务上的表现均显著差于社区对照样本。NET使训练过的记忆任务的表现有显著改善,但未训练的反应时间任务则无改善。在记忆任务上达到正常范围表现的精神分裂症患者比例有显著增加。
在至少一项记忆任务上存在损害的精神分裂症患者中,52%的患者因认知训练使其在至少一项此类任务上的表现恢复正常。结果表明,使用认知矫正可能实现具有临床意义的改善。