Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
Schizophr Res. 2018 Feb;192:335-339. doi: 10.1016/j.schres.2017.05.022. Epub 2017 May 23.
Cognitive remediation, often used in combination with standard rehabilitation programs, represents the best available tool to treat cognitive impairments in patients with schizophrenia. However, there are still open questions about durability of effects and generalization of cognitive improvements to functional outcome. This study aims to investigate the persistence of both cognitive and functional effects of combined cognitive remediation plus standard rehabilitation interventions, 5years after completion of the intervention, also comparing different durations of the standard rehabilitation. Sixty patients diagnosed with schizophrenia and previously treated with a 6months intervention, consisting of standard rehabilitation plus 3-months of cognitive remediation, either followed by another year of standard rehabilitation or routine psychiatric treatment, were reassessed with neuropsychological and functional measures 5years after the intervention. Results show that cognitive abilities remained stable after 5years in both groups, while functional performance significantly decreased in patients treated with the 6months intervention only. Data thus suggest that cognitive effects persist even after 5years, while a longer standard rehabilitation following the cognitive remediation program may be needed to achieve a stable functional gain.
认知矫正,通常与标准康复计划联合使用,是治疗精神分裂症患者认知障碍的最佳工具。然而,对于认知改善的效果持久度和对功能结果的推广仍存在一些问题。本研究旨在探讨联合认知矫正和标准康复干预措施的认知和功能效果的持久性,即干预完成后 5 年,同时比较不同时长的标准康复的效果。60 名被诊断患有精神分裂症的患者曾接受过为期 6 个月的治疗,包括标准康复加 3 个月的认知矫正,之后分别接受了 1 年的标准康复或常规精神科治疗,在干预结束 5 年后,他们接受了神经心理学和功能评估。结果表明,两组患者的认知能力在 5 年后仍保持稳定,而仅接受 6 个月干预的患者的功能表现则显著下降。数据表明,认知效果即使在 5 年后仍能持续,而在认知矫正计划之后进行更长时间的标准康复可能需要达到稳定的功能增益。