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精神分裂症中联合心理理论和认知矫正干预的稳定性和泛化:随访结果。

Stability and generalization of combined theory of mind and cognitive remediation interventions in schizophrenia: Follow-up results.

机构信息

Department of Clinical Neurosciences.

出版信息

Psychiatr Rehabil J. 2020 Jun;43(2):140-148. doi: 10.1037/prj0000379. Epub 2019 Aug 15.

Abstract

OBJECTIVE

Daily functional impairment is a main target of treatment in schizophrenia. Multiple rehabilitation treatments have been developed to improve patients' sociocognitive and neurocognitive abilities and to generalize the benefits to functioning. However, whether the effects of these treatments can be generalized and maintained remains equivocal. Our study aims to evaluate the stability and generalization of benefits, following combined Theory of Mind (ToM) and cognitive remediation (CR) trainings, compared with an active control group + CR, at a 3-year follow-up.

METHOD

Sixty-seven outpatients with schizophrenia who had completed an earlier study of ToM and CR were recruited for a 3-year follow-up assessment. We examined changes in ToM and functioning, at baseline, after treatment, and at follow-up.

RESULTS

ANOVAs showed significant Time × Group interactions on ToM and functioning. ANOVAs showed significant differences between groups in effect sizes of ToM and functioning from before treatment to follow-up.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

Posttraining ToM improvement was maintained at follow-up, and ToM + CR participants experienced greater functional improvement than participants in the control condition. This study represents the first attempt to report the stability and generalization of treatment effects obtained by combining CR and ToM interventions after 3 years. Combined sociocognitive and neurocognitive treatments can enhance rehabilitation practice for people with schizophrenia to achieve good results on both cognitive and functional outcomes and to maintain positive outcomes. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

摘要

目的

日常功能障碍是精神分裂症治疗的主要目标。已经开发出多种康复治疗方法来提高患者的社会认知和神经认知能力,并将益处推广到功能上。然而,这些治疗方法的效果是否可以推广和维持仍然存在争议。我们的研究旨在评估联合心理理论(ToM)和认知矫正(CR)训练后,与积极对照组+CR 相比,在 3 年随访时的益处的稳定性和推广。

方法

招募了 67 名完成早期心理理论和认知矫正研究的精神分裂症门诊患者进行 3 年随访评估。我们在基线、治疗后和随访时检查了心理理论和功能的变化。

结果

方差分析显示,心理理论和功能方面存在显著的时间×组间交互作用。方差分析显示,从治疗前到随访时,两组在心理理论和功能方面的效应量存在显著差异。

结论和对实践的启示

随访时,培训后的心理理论改善得到维持,并且与对照组相比,心理理论+CR 组的功能改善更大。这项研究首次尝试报告在 3 年后结合认知矫正和心理理论干预获得的治疗效果的稳定性和推广。联合社会认知和神经认知治疗可以增强精神分裂症患者的康复实践,在认知和功能结果上取得良好效果,并保持积极结果。(PsycInfo 数据库记录(c)2020 APA,保留所有权利)。

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