Department of Psychiatry, Spedali Civili Hospital, Brescia, Italy.
Curr Pharm Des. 2012;18(4):534-41. doi: 10.2174/138161212799316091.
The aim of cognitive remediation is to target the cognitive impairments of patients with psychosis, including attentional deficits, memory problems, and limitations in planning and problem solving. It is hoped that by addressing these deficits, patients will be more able to take advantage of other interventions and will be more able to function in social and other domains. Many results in controlled trials of cognitive remediation in adult patients affected by schizophrenia have demonstrated its effectiveness on different cognitive domains and on patient's functioning. Some researchers speculate that deficits in cognition are more amenable to remediation during earlier phases of illness than when chronicity has developed. For these reasons cognitive rehabilitation should be a key component of early intervention programs, seeking to produce durable functional changes in the early course of schizophrenia. Although there is strong evidence that cognitive remediation is effective in adult schizophrenia, there is little evidence about its efficacy and long-term generalized effectiveness in the early course of the disease, and its possible application in the prodromal phase of the disease.
The aim of this paper is to review the available literature on cognitive remediation in the prodromal phase and in the early course of schizophrenia. This review summarizes especially findings of cognitive changes induced in the early course or in the prodromal phases of schizophrenia by different remediation methods. Controlled studies of cognitive training are discussed in more detail.
Few studies on the effects of cognitive training programs have been conducted in first episode or in early schizophrenia and only one study has been conducted in the prodromal phase of the disease. Although preliminary positive results have been achieved, more empirical research is needed to confirm the efficacy of cognitive remediation in the early course of schizophrenia, and future studies should address the issue of the usefulness of cognitive remediation in the prodromes of psychosis.
认知矫正的目的是针对精神病患者的认知障碍，包括注意力缺陷、记忆问题、以及计划和解决问题的能力有限。人们希望通过解决这些缺陷，患者能够更好地利用其他干预措施，并在社交和其他领域更好地发挥作用。许多针对成人精神分裂症患者认知矫正的对照试验结果表明，认知矫正对不同认知领域和患者的功能都有效。一些研究人员推测，认知缺陷在疾病早期阶段比慢性阶段更容易矫正。基于这些原因，认知康复应该成为早期干预计划的关键组成部分，旨在在精神分裂症早期阶段产生持久的功能变化。尽管有强有力的证据表明认知矫正对成人精神分裂症有效，但关于其在疾病早期阶段的疗效和长期普遍有效性，以及在疾病前驱期的可能应用，证据很少。
本文旨在回顾认知矫正在精神分裂症前驱期和早期的现有文献。这篇综述特别总结了不同矫正方法在精神分裂症早期或前驱期引起的认知变化的发现。详细讨论了认知训练的对照研究。
只有一项研究在疾病前驱期进行了关于认知训练计划效果的研究，仅有一项研究在精神分裂症早期进行了关于认知训练计划效果的研究。尽管取得了初步的积极结果，但仍需要更多的实证研究来证实认知矫正对精神分裂症早期的疗效，未来的研究应解决认知矫正在精神病前驱期的有用性问题。
