Kidd Sean A, Herman Yarissa, Barbic Skye, Ganguli Rohan, George Tony P, Hassan Sabrina, McKenzie Kwame, Maples Natalie, Velligan Dawn
University of Toronto, Department of Psychiatry, Canada.
Toronto Centre for Addiction and Mental Health, 1001 Queen St. W., Toronto, Ontario, Canada, M6J 1H1.
Schizophr Res. 2014 Jun;156(1):46-50. doi: 10.1016/j.schres.2014.03.026. Epub 2014 Apr 29.
Cognitive adaptation training (CAT) is a home-based, manualized treatment that utilizes environmental supports to improve target behaviors and functional outcomes in persons with schizophrenia. Although clinical trials have shown CAT to be effective across functional, clinical, and treatment adherence domains, when the intervention is withdrawn clients experience significant declines. The aim of the current study was to test a modified version of CAT, which decreases the duration of intensive CAT intervention while utilizing ongoing case management-supported CAT to maintain the fundamental components of the treatment. Twenty-three people participated in an outcome study of the modified version of CAT, evaluating improvements after 4months of CAT specialist intervention and after an additional 5months of case manager support. Analysis revealed significant improvements in adaptive functioning, psychiatric symptomatology, and goal attainment, which were maintained throughout case management follow-up. This suggests that an intervention that has previously demonstrated good functional outcomes in randomized trials might sustain its impacts in an abbreviated format with support from existing case managers.
认知适应训练（CAT）是一种基于家庭的、手册化的治疗方法，它利用环境支持来改善精神分裂症患者的目标行为和功能结局。尽管临床试验表明CAT在功能、临床和治疗依从性领域均有效，但当干预措施停止时，患者的情况会显著恶化。本研究的目的是测试一种改良版的CAT，该版本缩短了强化CAT干预的时长，同时利用持续的个案管理支持的CAT来维持治疗的基本要素。23人参与了改良版CAT的结局研究，评估了CAT专家干预4个月后以及个案管理员额外支持5个月后的改善情况。分析显示，在适应性功能、精神症状学和目标达成方面有显著改善，且在整个个案管理随访期间这些改善得以维持。这表明，一种先前在随机试验中已证明具有良好功能结局的干预措施，在现有个案管理员的支持下，可能以简化形式维持其效果。
