基于智能手机的认知训练对精神分裂症功能/认知标志物的影响:一项为期一年的随机研究。

The Effect of Smartphone-Based Cognitive Training on the Functional/Cognitive Markers of Schizophrenia: A One-Year Randomized Study.

作者信息

Krzystanek Marek, Krysta Krzysztof, Borkowski Mariusz, Skałacka Katarzyna, Przybyło Jacek, Pałasz Artur, Mucic Davor, Martyniak Ewa, Waszkiewicz Napoleon

机构信息

Clinic of Psychiatric Rehabilitation, Department of Psychiatry and Psychotherapy, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Ziołowa 45/47, 40-635 Katowice, Poland.

Institute of Psychology, University of Opole, Kopernika 11A Street, 45-040 Opole, Poland.

出版信息

J Clin Med. 2020 Nov 16;9(11):3681. doi: 10.3390/jcm9113681.

Abstract

BACKGROUND

Cognitive impairment is associated with long-term disability that results in the deterioration of both the social and professional status of individuals with schizophrenia. The impact of antipsychotic therapy on cognitive function is insufficient. Cognitive training is therefore proposed as a tool for cognitive rehabilitation in schizophrenia. In this study we investigated the effect of self-administered cognitive training using a smartphone-based application on the cognitive function of paranoid schizophrenia patients focusing on response time, correct answer rate, incorrect answer rate, and fatigability to check, if these functions can be functional markers of successful cognitive-smartphone rehabilitation.

METHODS

1-year multicenter, open-label randomized study was conducted on 290 patients in a state of symptomatic remission. 191 patients were equipped with the full version of the application and conducted cognitive training twice a week. Reference group ( = 99) was provided with a version of the application having only limited functionality, testing the cognitive performance of patients every 6 months.

RESULTS

Statistically significant improvement was observed in both the rate of correct answers (by 4.8%, = 0.0001), and cognitive fatigability (by 2.9%, = 0.0001) in the study group, along with a slight improvement in the rate of incorrect answers (by 0.9%, = 0.15). In contrast, the reference group, who performed cognitive training every 6 months, demonstrated no significant changes in any cognitive activities.

CONCLUSIONS

Cognitive trainings facilitated by a smartphone-based application, performed regularly for a longer period of time are feasible and may have the potential to improve the cognitive functioning of individuals with schizophrenia. Correct answers and cognitive fatigability have potential to be functional markers of successful smartphone-based psychiatric rehabilitations in schizophrenia patients.

摘要

背景

认知障碍与长期残疾相关,这会导致精神分裂症患者的社会和职业地位下降。抗精神病治疗对认知功能的影响不足。因此,认知训练被提议作为精神分裂症认知康复的一种工具。在本研究中,我们调查了使用基于智能手机的应用程序进行自我管理的认知训练对偏执型精神分裂症患者认知功能的影响,重点关注反应时间、正确答案率、错误答案率和疲劳度,以检查这些功能是否可以作为成功的认知 - 智能手机康复的功能指标。

方法

对290名症状缓解状态的患者进行了为期1年的多中心、开放标签随机研究。191名患者安装了应用程序的完整版,并每周进行两次认知训练。对照组(n = 99)使用功能有限的应用程序版本,每6个月测试一次患者的认知表现。

结果

研究组的正确答案率(提高4.8%,P = 0.0001)和认知疲劳度(降低2.9%,P = 0.0001)有统计学意义的改善,错误答案率略有改善(提高0.9%,P = 0.15)。相比之下,每6个月进行一次认知训练的对照组在任何认知活动中均无显著变化。

结论

通过基于智能手机的应用程序进行的认知训练,长期定期进行是可行的,并且可能有潜力改善精神分裂症患者的认知功能。正确答案率和认知疲劳度有可能成为精神分裂症患者基于智能手机的成功精神康复的功能指标。

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