Byrne Linda K, Pan Lingyi, McCABE Marita, Mellor David, Xu Yifeng
School of Psychology, Deakin University, Melbourne, Australia.
Shanghai Mental Health Centre, Shanghai, China.
Shanghai Arch Psychiatry. 2015 Oct;27(5):296-306. doi: 10.11919/j.issn.1002-0829.215095.
Programs to remediate cognitive deficits have shown promising results in schizophrenia, but remediation of social cognition deficits is less well understood. Social cognitive deficits may cause more disability than the widely recognized neurocognitive deficits, suggesting that this is an area worthy of further investigation.
Implement and evaluate a brief computerized cognitive remediation program designed to improve memory, attention, and facial affect recognition (FAR) in outpatients with chronic schizophrenia.
Baseline assessments of FAR and of clinical, cognitive, and psychosocial functioning were completed on 20 males with schizophrenia enrolled in an outpatient rehabilitation program at the Shanghai Mental Health Center (the intervention group) and on 20 males with schizophrenia recruited from among regular outpatients at the Center (the control group). Both groups received treatment as usual, but the intervention group also completed an average of 12.7 sessions of a computer-based remediation program for neurocognitive, social, and FAR functioning over a 6-week period. The baseline measures were repeated in both groups at the end of the 6-week trial.
There were no statistically significant differences in the changes in clinical symptoms (assessed by the Positive and Negative Syndrome Scale, PANSS) or cognitive measures (assessed using the Hong Kong List Learning Test and the Letter-Number Sequencing Task) between the intervention and control groups over the 6-week trial, but there were modest improvements on the PANSS for the intervention group between baseline and after the intervention. There was a significantly greater improvement in the social functioning measure (the Personal and Social Performance scale, PSP) in the intervention group than in the control group. The pre-post change in the total facial recognition score in the intervention group was statistically significant (paired t-test=-2.60, p=0.018), and there was a statistical trend of a greater improvement in facial recognition in the intervention group than in the control group (F (1,37) =2.93; p=0.092).
Integration of FAR training with a short, computer-administrated cognitive remediation program may improve recognition of facial emotions by individuals with schizophrenia, and, thus, improve their social functioning. But more work on developing the FAR training modules and on testing them in larger, more diverse samples will be needed before this can be recommended as a standard part of cognitive remediation programs.
针对认知缺陷的干预项目在精神分裂症治疗中已显示出有前景的结果，但社会认知缺陷的干预效果尚鲜为人知。社会认知缺陷可能比广泛认可的神经认知缺陷导致更多的功能障碍，这表明该领域值得进一步研究。
实施并评估一个简短的计算机化认知康复项目，旨在改善慢性精神分裂症门诊患者的记忆、注意力和面部表情识别（FAR）能力。
对20名在上海精神卫生中心门诊康复项目中登记的男性精神分裂症患者（干预组）和20名从该中心普通门诊患者中招募的男性精神分裂症患者（对照组）完成FAR以及临床、认知和心理社会功能的基线评估。两组均接受常规治疗，但干预组在6周内平均完成了12.7节基于计算机的神经认知、社会和FAR功能康复项目。在6周试验结束时，对两组重复进行基线测量。
在6周试验期间，干预组和对照组在临床症状变化（通过阳性和阴性症状量表，PANSS评估）或认知测量（使用香港记忆学习测试和字母数字排序任务评估）方面无统计学显著差异，但干预组在基线至干预后PANSS有适度改善。干预组的社会功能测量（个人和社会表现量表，PSP）改善显著大于对照组。干预组面部识别总分的前后变化具有统计学意义（配对t检验=-2.60，p=0.018），且干预组面部识别改善大于对照组有统计学趋势（F(1,37)=2.93；p=0.092）。
将FAR训练与简短的计算机辅助认知康复项目相结合，可能改善精神分裂症患者对面部情绪的识别，从而改善其社会功能。但在将其推荐为认知康复项目的标准组成部分之前，需要开展更多工作来开发FAR训练模块并在更大、更多样化的样本中进行测试。
