Royer Aurélie, Grosselin Anne, Bellot Cécile, Pellet Jacques, Billard Stéphane, Lang François, Brouillet Denis, Massoubre Catherine
Department of Psychiatry, University Hospital, Saint-Etienne, France.
Cogn Neuropsychiatry. 2012;17(1):19-35. doi: 10.1080/13546805.2011.564512. Epub 2011 Jun 28.
Cognitive deficits are commonly reported in schizophrenia and have a significant impact on the daily life of patients and on their social and work inclusion. Cognitive remediation therapies (CRT) may enhance the capabilities of schizophrenia patients. Although social and work integration is the ultimate goal of CRT, previous studies have failed to carry out a detailed assessment of the effects on everyday life.
Fifty-nine schizophrenia patients were randomised into two groups (remediation or usual treatment) to test the effects of a new remediation programme, which included both rehearsal and strategy learning, on cognitive functions. An ecological test was used to evaluate its transfer to daily living skills.
Cognitive improvements are revealed in CRT patients, mainly in memory and executive functions. Patients showing some deficiencies to perform the ecological test had better scores after the CRT. Moreover, they significantly improve their social activity scores.
CRT would facilitate mental load monitoring by enhancing or reallocating cognitive resources, facilitating the patient's organisation and autonomy. The rehearsal learning approach improves the ability to carry out automatic operations that are less demanding in terms of cognitive resources, thereby increasing the resources available for acquisition and efficient use of strategies provided during the strategy learning approach.
认知缺陷在精神分裂症中很常见，对患者的日常生活以及他们融入社会和工作有着重大影响。认知康复疗法（CRT）可能会提高精神分裂症患者的能力。尽管社会和工作融合是CRT的最终目标，但先前的研究未能对其对日常生活的影响进行详细评估。
将59名精神分裂症患者随机分为两组（康复组或常规治疗组），以测试一种新的康复方案（包括演练和策略学习）对认知功能的影响。采用生态测试来评估其向日常生活技能的转化。
CRT组患者的认知功能有所改善，主要体现在记忆和执行功能方面。在进行生态测试时表现出一些缺陷的患者在接受CRT后得分更高。此外，他们的社交活动得分显著提高。
CRT通过增强或重新分配认知资源，促进患者的组织能力和自主性，从而有助于心理负荷监测。演练学习方法提高了执行对认知资源要求较低的自动操作的能力，从而增加了可用于获取和有效使用策略学习方法中所提供策略的资源。
