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认知增强治疗对早期精神分裂症功能结局影响的一年耐久性。

One-year durability of the effects of cognitive enhancement therapy on functional outcome in early schizophrenia.

机构信息

School of Social Work, University of Pittsburgh, PA, USA.

出版信息

Schizophr Res. 2010 Jul;120(1-3):210-6. doi: 10.1016/j.schres.2010.03.042. Epub 2010 May 15.

Abstract

Cognitive rehabilitation is an effective intervention for addressing cognitive impairments in patients with schizophrenia. Previous research has shown that the early application of Cognitive Enhancement Therapy (CET) can improve neurocognitive and social-cognitive deficits in the early course of the disorder, and ultimately reduce the substantial functional disability that these patients experience. However, the lasting effects of CET on functional outcome in early course schizophrenia patients remain unknown. In this study, 58 patients in the early course of schizophrenia or schizoaffective disorder treated with 2 years of either CET or an Enriched Supportive Therapy (EST) control were followed-up 1 year after the completion of treatment to examine the durability of CET effects on functional outcome. At one-year post-treatment, a high (72%) retention rate was observed in both treatments. Results from intent-to-treat analyses employing linear mixed-effects models indicated that CET effects on functional outcome were broadly maintained one-year post-treatment, and that patients receiving CET continued to demonstrate highly significant differential functional benefits compared to patients treated with EST. These findings support the durability of CET effects on functional outcome in the early course of schizophrenia, and point to the potential of cognitive rehabilitation to have a lasting impact on the early trajectory of the disorder.

摘要

认知康复是一种有效的干预措施,可用于解决精神分裂症患者的认知障碍。先前的研究表明,早期应用认知增强治疗(CET)可以改善疾病早期的神经认知和社会认知缺陷,并最终减少这些患者经历的大量功能障碍。然而,CET 对早期精神分裂症患者的功能结果的持久影响尚不清楚。在这项研究中,对接受 2 年 CET 或强化支持治疗(EST)对照治疗的早期精神分裂症或分裂情感障碍的 58 名患者进行了 1 年的随访,以检查 CET 对功能结果的持久影响。在治疗结束后 1 年,两种治疗方法的保留率均高达 72%。意向治疗分析的线性混合效应模型结果表明,CET 对功能结果的影响在治疗结束后 1 年内基本保持不变,并且接受 CET 的患者与接受 EST 治疗的患者相比,继续表现出显著的功能差异获益。这些发现支持了 CET 在精神分裂症早期对功能结果的持久影响,并表明认知康复有可能对疾病的早期轨迹产生持久影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99da/2900399/ed56e964e921/nihms206356f1.jpg

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