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首发精神分裂症患者的代偿性认知训练:一项试点随机对照试验的结果

Compensatory cognitive training for people with first-episode schizophrenia: results from a pilot randomized controlled trial.

作者信息

Mendella Paul D, Burton Cynthia Z, Tasca Giorgio A, Roy Paul, St Louis Lea, Twamley Elizabeth W

机构信息

Ricci & Associates, 1101 Prince of Wales Drive, Suite 110, Ottawa, ON K2C 3W7, Canada.

San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, 140 Arbor Drive (0851), San Diego, CA 92103, United States.

出版信息

Schizophr Res. 2015 Mar;162(1-3):108-11. doi: 10.1016/j.schres.2015.01.016. Epub 2015 Jan 24.

Abstract

Cognitive training or remediation now has multiple studies and meta-analyses supporting its efficacy in improving cognition and functioning in people with schizophrenia. However, relatively little is known about cognitive training outcomes in early psychosis. We conducted a pilot randomized controlled trial of Compensatory Cognitive Training (CCT) compared to Treatment as Usual (TAU) in 27 participants with first-episode psychosis who had received treatment for psychosis for less than six months. Assessments of cognition (MATRICS Consensus Cognitive Battery; MCCB) and functional capacity (UCSD Performance-Based Skills Assessment-Brief; UPSA-B) were administered at baseline and following the 12-week treatment. The CCT condition, compared to TAU, was associated with significant improvements on the MCCB composite score, as well as MCCB subtests measuring processing speed (Trail Making) and social cognition (Mayer-Salovey-Caruso Emotional Intelligence Test), with large effects on these three outcome measures. There were no significant CCT-associated effects on the UPSA-B or on positive, negative, or depressive symptoms. CCT treatment of cognitive impairments in first-episode schizophrenia is feasible and can result in large effect size improvements in global cognition, processing speed, and social cognition.

摘要

认知训练或康复目前已有多项研究和荟萃分析支持其在改善精神分裂症患者认知和功能方面的疗效。然而,对于早期精神病患者的认知训练结果却知之甚少。我们对27名首次发作精神病且接受精神病治疗不到6个月的参与者进行了一项补偿性认知训练(CCT)与常规治疗(TAU)对比的试点随机对照试验。在基线期和12周治疗后进行了认知评估(MATRICS共识认知成套测验;MCCB)和功能能力评估(基于加州大学圣地亚哥分校表现的技能评估简版;UPSA-B)。与TAU相比,CCT组在MCCB综合得分以及测量加工速度(连线测验)和社会认知(梅耶-萨洛维-卡鲁索情商测验)的MCCB子测验上有显著改善,对这三项结果指标有较大影响。CCT对UPSA-B或阳性、阴性或抑郁症状没有显著影响。对首发精神分裂症的认知障碍进行CCT治疗是可行的,并且可以在整体认知、加工速度和社会认知方面带来较大效应量的改善。

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