Division of Biological Psychiatry, Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Innsbruck, Austria.
J Stud Alcohol Drugs. 2012 Jul;73(4):625-34. doi: 10.15288/jsad.2012.73.625.
Cognitive impairments in individuals with alcohol dependence may interfere with the progress of treatment and contribute to the progression of the disease. This study aimed to determine whether cognitive remediation (CR) therapy applied during treatment for alcohol dependence improves cognitive functioning in alcohol-dependent inpatients. A secondary aim was to evaluate whether the benefits of CR generalize to noncognitive clinically meaningful outcomes at the end of inpatient treatment.
Forty-one alcohol-dependent patients entering inpatient treatment for alcohol dependence were randomly assigned to receive conventional treatment (n = 21) or an additional 12 sessions of computer-assisted CR focusing on cognitive enhancement in attention/executive function and memory domains (n = 20). Assessments of cognitive abilities in these domains as well as of psychological well-being and alcohol craving were conducted at baseline (at the beginning of inpatient treatment) and after CR (at the end of treatment).
Results indicated that, relative to patients completing conventional treatment, those who received supplemental CR showed significant improvement in attention/executive function and memory domains, particularly in attention (alertness, divided attention), working memory, and delayed memory (recall). In addition, patients receiving CR during alcohol-dependence treatment showed significantly greater improvements in psychological well-being (Symptom Checklist-90-Revised) and in the compulsion aspect of craving (Obsessive Compulsive Drinking Scale-German version).
CR during inpatient treatment for alcohol dependence is effective in improving cognitive impairments in alcohol-dependent patients. The benefits generalize to noncognitive outcomes, demonstrating that CR may be an efficacious adjunctive intervention for the treatment of alcohol dependence.
酒精依赖个体的认知障碍可能会干扰治疗进展，并导致疾病进展。本研究旨在确定在治疗酒精依赖期间应用认知矫正（CR）疗法是否能改善酒精依赖住院患者的认知功能。次要目的是评估 CR 是否能在住院治疗结束时对非认知性临床有意义的结果产生有益影响。
41 名酒精依赖患者进入酒精依赖住院治疗，随机分为接受常规治疗（n=21）或额外 12 次计算机辅助 CR 治疗（n=20），CR 侧重于注意力/执行功能和记忆领域的认知增强。在基线（住院治疗开始时）和 CR 后（治疗结束时）对这些领域的认知能力以及心理幸福感和酒精渴求进行评估。
结果表明，与完成常规治疗的患者相比，接受补充 CR 的患者在注意力/执行功能和记忆领域的表现有显著改善，特别是在注意力（警觉性、分散注意力）、工作记忆和延迟记忆（回忆）方面。此外，在酒精依赖治疗期间接受 CR 的患者在心理幸福感（症状清单 90 修订版）和渴求的强迫方面（德国版强迫性饮酒量表）有显著更大的改善。
酒精依赖住院治疗期间的 CR 有效改善了酒精依赖患者的认知障碍。益处扩展到非认知结果，表明 CR 可能是治疗酒精依赖的有效辅助干预措施。
