针对精神分裂症患者，在日常临床实践中成功实施认知康复计划。

Successful implementation of a cognitive remediation program in everyday clinical practice for individuals living with schizophrenia.

作者信息

John Alexander Panickacheril, Yeak Kim, Ayres Helen, Dragovic Milan

机构信息

School of Psychiatry and Clinical Neurosciences, University of Western Australia.

Mental Health Service, Royal Perth Bentley Group.

出版信息

Psychiatr Rehabil J. 2017 Mar;40(1):87-93. doi: 10.1037/prj0000255.

DOI:10.1037/prj0000255

PMID:28368182

Abstract

OBJECTIVE

This article evaluates the feasibility and benefits of implementing cognitive remediation interventions in everyday clinical practice among individuals living with schizophrenia.

METHOD

We retrospectively assessed short-term cognitive and occupational outcomes of 89 consecutively admitted people with schizophrenia at a public mental health service. A computerized cognitive remediation program was offered at the facility as an integral component of psychosocial treatments. Data of service recipients who had completed the Brief Assessment of Cognition in Schizophrenia (BACS; Keefe et al., 2004) on admission and discharge were included for evaluating outcomes.

RESULTS

Thirty-seven service recipients did not participate (nontrainee), 18 completed less than 20 hr (incomplete trainee), and 34 completed more than 20 hr of cognitive remediation (completed trainee). Whist a variety of factors affected involvement, lack of interest was the predominant reason voiced for nonparticipation. Repeated measures analysis of variance did not reveal significant Group × Time interaction. Exploratory contrasts showed statistically significant improvement within the completed trainee group from baseline to discharge on the BACS composite score, list learning, and token motor task. Logistic regression analysis indicated that although improved cognition predicted enhanced employment outcome, there was no significant difference among the 3 groups.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

Cognitive remediation interventions were accepted by a sizable proportion of people with schizophrenia admitted to an inpatient clinical treatment and rehabilitation facility. Promising improvement in cognitive function among those who completed the training suggests the need for methodologically rigorous research exploring the feasibility and benefits of cognitive remediation programs at everyday clinical settings. (PsycINFO Database Record

摘要

目的

本文评估在精神分裂症患者的日常临床实践中实施认知康复干预措施的可行性和益处。

方法

我们回顾性评估了一家公共心理健康服务机构中89名连续入院的精神分裂症患者的短期认知和职业结局。该机构提供了一个计算机化认知康复项目，作为心理社会治疗的一个组成部分。纳入了在入院和出院时完成了精神分裂症认知简短评估（BACS；Keefe等人，2004年）的服务接受者的数据，以评估结局。

结果

37名服务接受者未参与（非受训者），18名完成的时间少于20小时（未完成受训者），34名完成了超过20小时的认知康复（完成受训者）。虽然多种因素影响参与情况，但缺乏兴趣是未参与的主要原因。重复测量方差分析未显示出显著的组×时间交互作用。探索性对比显示，在完成受训者组中，从基线到出院，BACS综合评分、列表学习和代币运动任务有统计学上的显著改善。逻辑回归分析表明，虽然认知改善预示着就业结局的改善，但三组之间没有显著差异。