Franck N
Centre de Réhabilitation, Hôpital du Vinatier, Université Lyon 1 & UMR 5229 (CNRS), France.
Encephale. 2010 Mar;36 Suppl 3:S58-65. doi: 10.1016/S0013-7006(10)70032-4.
Cognitive remediation is efficient to treat cognitive disorders associated with schizophrenia. Since (i) these disorders play a negative role in functional outcome and (ii) antipsychotics do not improve significantly cognition, cognitive remediation should be systematically used with patients with schizophrenia and after the first episode of psychosis. A comprehensive neuropsychological assessment, that precedes the beginning of cognitive remediation, allows targeting the most impaired cognitive domains. Cognitive remediation intervention takes place after symptoms stabilization. It needs also that the antipsychotic treatment was prescribed at minimal fully effective dose and that the patients have acquired a minimal understanding of their disease (i.e. after psychoeducation). Cognitive remediation programs that have been validated for schizophrenia (NEAR, CET, NET, IPT, CRT…) can be used after the first episode of psychosis.
认知矫正对于治疗与精神分裂症相关的认知障碍是有效的。由于（i）这些障碍对功能结局起负面作用，且（ii）抗精神病药物对认知的改善并不显著，因此认知矫正应系统地应用于精神分裂症患者及首次精神病发作后。在认知矫正开始前进行全面的神经心理学评估，有助于针对受损最严重的认知领域。认知矫正干预在症状稳定后进行。这还需要抗精神病治疗已以最低有效剂量开具，且患者对其疾病有了最低限度的了解（即经过心理教育之后）。已被证实对精神分裂症有效的认知矫正项目（NEAR、CET、NET、IPT、CRT…）可在首次精神病发作后使用。
