Perna Giampaolo, Daccò Silvia, Sacco Ferdinando, Micieli Wilma, Cavedini Paolo, Caldirola Daniela
Department of Clinical Neurosciences, Hermanas Hospitalarias, Villa San Benedetto Menni Hospital, FoRiPsi, Albese con Cassano, Como, Italy.; Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, University of Maastricht, Maastricht, Netherlands.; Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, University of Miami, Miami, FL, USA.
Department of Clinical Neurosciences, Hermanas Hospitalarias, Villa San Benedetto Menni Hospital, FoRiPsi, Albese con Cassano, Como, Italy.
Psychiatry Investig. 2017 Jan;14(1):8-15. doi: 10.4306/pi.2017.14.1.8. Epub 2016 Dec 29.
Our pilot study aims to investigate the efficacy of a Short-Term (4 weeks) Psychiatric Rehabilitation Program (S-T PsyRP), without specific cognitive remediation trainings, on the neuropsychological performance and psychosocial functioning of inpatients with Major Depressive Disorder (MDD) or Bipolar Disorder (BD). Published studies with similar aims are lacking.
Fifty-three inpatients with MDD and 27 with BD (type I/II) were included. The S-T PsyRP was usually performed as clinical practice at Villa San Benedetto Menni Hospital and included a variety of activities aimed at promoting personal autonomies, interpersonal/social skills, and self-care. At the beginning and the end of the hospitalization we evaluated: neuropsychological performance (cognitive tests on verbal/visual working memory, attention, visual-constructive ability, language fluency, and comprehension); psychosocial functioning by the Rehabilitation Areas Form (RAF, handbook VADO); illness severity by the Brief Psychiatric Rating Scale (BPRS). Repeated-measure ANOVA and Pearson's linear correlation were used.
We found significant improvement (p<0.01) in all the neuropsychological tests except for one, in 4 out of 6 RAF psychosocial areas ("involvement in ward activities", "autonomies", "self-care", and "self-management of health") and in clinical symptoms severity. No associations were found between the amelioration of clinical symptoms and neuropsychological or psychosocial improvement.
A S-T PsyRP without specific cognitive remediation trainings may improve several cognitive/functional domains in MDD or BD inpatients, probably by offering opportunities to engage in demanding problem-solving conditions and cognitively stimulating activities.
我们的初步研究旨在调查一项短期（4周）精神康复计划（S-T PsyRP）在无特定认知康复训练的情况下，对重度抑郁症（MDD）或双相情感障碍（BD）住院患者的神经心理表现和心理社会功能的疗效。目前缺乏具有类似目的的已发表研究。
纳入53例MDD住院患者和27例BD（I/II型）住院患者。S-T PsyRP通常在圣贝内代托·门尼别墅医院作为临床实践进行，包括各种旨在促进个人自主性、人际/社交技能和自我护理的活动。在住院开始和结束时，我们评估了：神经心理表现（对言语/视觉工作记忆、注意力、视觉建构能力、语言流畅性和理解能力的认知测试）；通过康复领域表格（RAF，VADO手册）评估心理社会功能；通过简明精神病评定量表（BPRS）评估疾病严重程度。使用重复测量方差分析和皮尔逊线性相关分析。
我们发现，除一项神经心理测试外，所有神经心理测试均有显著改善（p<0.01），6个RAF心理社会领域中的4个（“参与病房活动”、“自主性”、“自我护理”和“健康自我管理”）以及临床症状严重程度均有改善。临床症状的改善与神经心理或心理社会改善之间未发现关联。
一项无特定认知康复训练的S-T PsyRP可能会改善MDD或BD住院患者的几个认知/功能领域，可能是通过提供参与具有挑战性的问题解决情境和认知刺激活动的机会。
