Matsui Mié, Arai Hirofumi, Yonezawa Mineo, Sumiyoshi Tomiki, Suzuki Michio, Kurachi Masayoshi
Department of Neuropsychology, Graduate School of Medicine, University of Toyama, Toyama 930-0194, Japan.
Appl Neuropsychol. 2009 Jul;16(3):158-64. doi: 10.1080/09084280903098414.
This study examined the extent to which cognitive rehabilitation alleviates cognitive deficits in schizophrenia compared to treatment as usual, and explored the mediating and moderating effects on cognitive improvement. Two groups who received cognitive rehabilitation and treatment as usual were assessed at baseline, three months (immediately post-intervention) and at follow-up (three months post-intervention). Cognitive rehabilitation focused on deficits in social knowledge and was conducted once a week for three months. The principles of errorless leaning and scaffolding informed the intervention. Outcomes were assessed using Script Test measures of social cognition. Other cognitive functions (executive functions and memory) and clinical symptoms were also assessed. Script Test for social knowledge and Rule Shift Test for cognitive flexibility scores were significantly better post-intervention in the cognitive rehabilitation group, while in the control group only free recall Script Test scores improved. Cognitive rehabilitation focused on social knowledge deficits can contribute to improvements in the social cognitive abilities of schizophrenic patients. Improvements in social cognitive functioning were durable at three-month follow-up. Cognitive rehabilitation can clearly benefit schizophrenic patients, at least when combined with atypical antipsychotic medication.
本研究考察了与常规治疗相比，认知康复在多大程度上减轻了精神分裂症患者的认知缺陷，并探讨了其对认知改善的中介和调节作用。对接受认知康复和常规治疗的两组患者在基线、三个月（干预后即刻）和随访（干预后三个月）时进行评估。认知康复聚焦于社会知识缺陷，为期三个月，每周进行一次。干预采用无错误学习和支架搭建原则。使用社会认知的脚本测试指标评估结果。还评估了其他认知功能（执行功能和记忆）及临床症状。认知康复组干预后社会知识的脚本测试和认知灵活性的规则转换测试得分显著更好，而在对照组中只有自由回忆脚本测试得分有所改善。聚焦于社会知识缺陷的认知康复有助于改善精神分裂症患者的社会认知能力。社会认知功能的改善在三个月随访时具有持续性。认知康复至少在与非典型抗精神病药物联合使用时，能明显使精神分裂症患者受益。
