Department of Psychiatry, University of California, San Diego, 140 Arbor Drive, San Diego, CA 92103, USA.
Schizophr Bull. 2011 Sep;37 Suppl 2(Suppl 2):S55-62. doi: 10.1093/schbul/sbr059.
Enhancing cognitive performance to improve functioning in schizophrenia is a fundamental research priority. Previous investigations have demonstrated that various types of cognitive training (CT) can improve neuropsychological performance, psychosocial functioning, and psychiatric symptom severity. However, there is limited information about individual differences that may predict CT response and adherence to treatment. The purpose of this study was to identify who is likely to drop out of this type of study as well as this type of intervention and to explore individual factors predicting treatment outcome. Participants included 89 outpatients diagnosed with a primary psychotic disorder who enrolled in a randomized controlled trial of compensatory CT and were assessed at baseline, 3 months (posttest), and 6 months (follow-up). Study completers had more formal education and lower daily doses of antipsychotic medications than did dropouts with no CT exposure, but the groups did not otherwise differ. There were no significant differences between participants who completed CT and those who began CT but later dropped out. CT-associated improvement was correlated with worse baseline scores on measures of cognitive performance, symptom severity, functional capacity, and self-rated quality of life, cognitive problems, and strategy use. These results suggest that those with lower baseline functioning may have more room to improve following CT. The pattern of correlations in this sample indicated that many types of individuals can improve with CT treatment, including older patients.
提高精神分裂症患者的认知表现以改善其功能是一项基本的研究重点。先前的研究表明，各种类型的认知训练（CT）可以改善神经心理学表现、社会心理功能和精神症状严重程度。然而，关于可能预测 CT 反应和治疗依从性的个体差异的信息有限。本研究的目的是确定哪些人可能会退出这种类型的研究以及这种类型的干预，并探讨预测治疗结果的个体因素。参与者包括 89 名被诊断为原发性精神障碍的门诊患者，他们参加了一项补偿性 CT 的随机对照试验，并在基线、3 个月（后测）和 6 个月（随访）进行评估。完成 CT 的参与者比没有接受 CT 暴露的脱落者接受了更多的正规教育，且每日抗精神病药物剂量较低，但两组在其他方面没有差异。完成 CT 的参与者和开始 CT 但后来退出的参与者之间没有显著差异。与 CT 相关的改善与认知表现、症状严重程度、功能能力和自我报告的生活质量、认知问题和策略使用的基线评分较差相关。这些结果表明，在 CT 后，基线功能较低的人可能有更多的改善空间。该样本中的相关模式表明，许多类型的个体都可以通过 CT 治疗得到改善，包括老年患者。
