Choi Kee-Hong, Kang Jinsook, Kim Sun-Min, Lee Seung-Hwan, Park Seon-Cheol, Lee Won-Hye, Choi Sun, Park Kiho, Hwang Tae-Yeon
Department of Psychology, Korea University, Seoul, South Korea.
Department of Psychiatry, Inje University College of Medicine and Ilsan Paik Hospital, Goyang, South Korea.
Front Psychol. 2018 Feb 6;8:2364. doi: 10.3389/fpsyg.2017.02364. eCollection 2017.
Accumulating evidence indicates that cognitive remediation (CR) is effective for improving various cognitive deficits in adult patients with schizophrenia. Although reports of brain plasticity in older adults and the service needs for chronic patients with schizophrenia are increasing, very few randomized controlled trials of CR have been conducted in middle-aged or older inpatients with chronic schizophrenia. We investigated the efficacy of individualized CR on the cognitive impairments of middle-aged or older inpatients with chronic schizophrenia within the context of comprehensive psychiatric rehabilitation (PR) by comparing the results obtained with PR only and treatment as usual (TAU). Fifty-seven middle-aged and older individuals with chronic schizophrenia and mild to moderate cognitive deficits were enrolled. Thirty-eight who were undergoing PR were randomly assigned to CR + PR ( = 19) or PR-only ( = 19) groups. Nineteen participants who were undergoing TAU without CR or PR were evaluated pre- and post-treatment. CR was easily provided and well received (drop-out rates = 5.3%) by middle-aged or older psychiatric inpatients. Compared to the PR-Only or TAU patients, patients in the CR + PR group showed greater improvement in executive functioning. Compared to TAU patients, CR + PR and PR-only patients showed greater improvement in logical memory. More patients in the CR + PR group improved clinically significantly in executive functioning and logical memory, compared with the PR-only and TAU patients. These results suggested that CR improved some cognitive deficits in middle-aged or older inpatients with chronic schizophrenia and that it was effective as an adjunctive treatment to the usual PR services provided in inpatient settings. KCT0002609.
越来越多的证据表明，认知康复（CR）对于改善成年精神分裂症患者的各种认知缺陷是有效的。尽管关于老年人脑可塑性的报道以及慢性精神分裂症患者的服务需求不断增加，但针对中年或老年慢性精神分裂症住院患者进行的CR随机对照试验却非常少。我们通过比较仅接受综合精神康复（PR）和常规治疗（TAU）所获得的结果，研究了个体化CR在综合精神康复背景下对中年或老年慢性精神分裂症住院患者认知障碍的疗效。招募了57名患有慢性精神分裂症且有轻度至中度认知缺陷的中年及老年个体。38名正在接受PR的患者被随机分配到CR + PR组（ = 19）或仅PR组（ = 19）。19名正在接受TAU但未接受CR或PR的参与者在治疗前后接受了评估。CR很容易提供，并且受到中年或老年精神科住院患者的好评（脱落率 = 5.3%）。与仅接受PR或TAU的患者相比，CR + PR组的患者在执行功能方面有更大改善。与TAU患者相比，CR + PR组和仅PR组的患者在逻辑记忆方面有更大改善。与仅接受PR和TAU的患者相比，CR + PR组有更多患者在执行功能和逻辑记忆方面有临床显著改善。这些结果表明，CR改善了中年或老年慢性精神分裂症住院患者的一些认知缺陷，并且作为住院环境中常规PR服务的辅助治疗是有效的。KCT0002609。
