Hegde Shantala
Neuropsychology Unit, Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru-560029, Karnataka, India.
Asian J Psychiatr. 2017 Feb;25:54-59. doi: 10.1016/j.ajp.2016.10.001. Epub 2016 Oct 11.
Cognitive deficits play a central role in recovery from Schizophrenia (SZ). Cognitive remediation (CR) is increasingly being examined to improve cognitive functions in SZ. It is becoming an inevitable component of treatment for this debilitating illness. This review article presents the current status of research on CR for SZ in India. In contrast to the numerous studies reported from across the globe, there are only five studies on CR for SZ published from India. Of the five, only two are randomized controlled trials, two are non-randomized studies and one is a series of case reports. With different strategies used for CR and a variety of tools and measurements as outcome measures, combined analysis of the data was not feasible. Improvement in cognitive functions and sustenance of the improvement observed at follow-up period ranging from 2 to 6 months duration was underscored by all the four studies. Indigenous methods such as home-based CR techniques and Yoga therapy as an adjunct CR technique have been researched upon. Established method of CR such as the Integrated Psychological Therapy (IPT) has been used with modifications made to suit the cultural scenario. Other treatment methods such as family therapy have been added along with CR for chronic patients. The limited number of research studies has tried to encompass various dimensions. However, there is a dire need for studies with larger sample size with stringent research methods. Culturally feasible CR technique and multi-centric studies with larger sample size can be the next way forward.
认知缺陷在精神分裂症（SZ）的康复中起着核心作用。认知康复（CR）正越来越多地被用于改善SZ患者的认知功能。它正成为这种使人衰弱疾病治疗中不可或缺的一部分。这篇综述文章介绍了印度针对SZ的CR研究现状。与全球各地报道的大量研究相比，印度仅发表了五项关于SZ的CR研究。其中，只有两项是随机对照试验，两项是非随机研究，一项是系列病例报告。由于用于CR的策略不同，且作为结局指标的工具和测量方法多种多样，因此对数据进行综合分析是不可行的。所有四项研究都强调了认知功能的改善以及在2至6个月随访期内观察到的改善的持续性。已经对诸如家庭式CR技术和瑜伽疗法作为辅助CR技术等本土方法进行了研究。已采用的CR既定方法，如综合心理治疗（IPT），已根据文化背景进行了修改。对于慢性病患者，除了CR之外，还增加了其他治疗方法，如家庭治疗。数量有限的研究试图涵盖各个方面。然而，迫切需要采用更严格研究方法、更大样本量的研究。文化上可行的CR技术以及更大样本量的多中心研究可能是下一步的方向。
