Bossert Magdalena, Westermann Celina, Schilling Thomas M, Weisbrod Matthias, Roesch-Ely Daniela, Aschenbrenner Steffen
Department of Clinical Psychology and Neuropsychology, SRH Klinikum Karlsbad-Langensteinbach, Karlsbad, Germany.
Department of Psychiatry und Psychotherapy, SRH Klinikum Karlsbad-Langensteinbach, Karlsbad, Germany.
Front Psychiatry. 2020 Sep 16;11:555052. doi: 10.3389/fpsyt.2020.555052. eCollection 2020.
Computer-assisted cognitive remediation (CACR) is an economical, adjustable, and effective treatment for individuals with schizophrenia. The current randomized controlled study examined whether an individualized or generic exercise plan in CACR is superior in patients with multiple cognitive deficits compared to treatment-as-usual (TAU). Fifty-nine inpatients diagnosed with schizophrenia were randomly assigned to 1) TAU, 2) TAU plus an individualized exercise plan in CACR, or 3) TAU plus a generic exercise plan in CACR. Neuropsychological performance, psychopathology, and functional outcome were assessed at baseline and post-treatment. The results show a medium to large training effect for all neuropsychological performance measures. Contrary to our expectations the neuropsychological improvement over time did not differ between groups. Self-reported depression, global level of functioning, and activity and participation functioning showed a significant improvement from baseline to post-treatment. However no further group, time, or interaction effects for other psychopathology and functional outcome could be demonstrated. Possible implications for clinical use of CACR and future studies are discussed.
计算机辅助认知康复(CACR)是一种针对精神分裂症患者的经济、可调整且有效的治疗方法。当前的随机对照研究考察了在患有多种认知缺陷的患者中,CACR中的个性化或通用运动计划与常规治疗(TAU)相比是否更具优势。59名被诊断为精神分裂症的住院患者被随机分配到1)TAU组,2)TAU加CACR中的个性化运动计划组,或3)TAU加CACR中的通用运动计划组。在基线和治疗后评估神经心理表现、精神病理学和功能结局。结果显示,所有神经心理表现指标均有中等到较大的训练效果。与我们的预期相反,随着时间推移,各组之间的神经心理改善情况并无差异。自我报告的抑郁、整体功能水平以及活动和参与功能从基线到治疗后均有显著改善。然而,对于其他精神病理学和功能结局,未发现进一步的组间、时间或交互效应。文中讨论了CACR临床应用的可能意义及未来研究方向。