Vidarsdottir Olina G, Roberts David L, Twamley Elizabeth W, Gudmundsdottir Berglind, Sigurdsson Engilbert, Magnusdottir Brynja B
Department of Psychiatry, Landspitali-The National University Hospital, Reykjavik, Iceland.
Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
Front Psychiatry. 2021 Jan 14;11:624091. doi: 10.3389/fpsyt.2020.624091. eCollection 2020.
Many individuals demonstrate functionally relevant impairment in neurocognition as well as social cognition early on in the course of their psychotic disorder. There is robust evidence supporting cognitive remediation as an effective treatment of cognitive dysfunction in schizophrenia. Increasingly it is accepted that earlier treatment is associated with better outcome and that it is important to systematically assess and treat cognitive dysfunction before the cognitive and functional disabilities are fully realized. However, the clinical availability of these interventions remains sparse. As we move forward with implementing evidence-based interventions into multi-component treatment for early psychosis, it is important to reflect on experience as well as evidence. This case report aims to describe the implementation of an integrative cognitive remediation program in coordinated specialty care (CSC) for early psychosis in Iceland and investigate whether the intervention is sustainable in a CSC setting. Data on the number of patients treated, facilitators trained, groups conducted, and funding was used to assess the sustainability. The results show that since initial implementation in 2016, the intervention has been routinely available as part of standard care, with over 100 patients having received the treatment. The report discusses key factors in the successful implementation of the program.
许多个体在其精神障碍病程早期就表现出神经认知以及社会认知方面与功能相关的损害。有充分证据支持认知康复作为精神分裂症认知功能障碍的有效治疗方法。越来越多的人认识到，早期治疗与更好的预后相关，并且在认知和功能残疾完全显现之前，系统地评估和治疗认知功能障碍非常重要。然而，这些干预措施在临床上的可及性仍然很少。当我们推进将循证干预措施纳入早期精神病的多成分治疗时，反思经验和证据很重要。本病例报告旨在描述冰岛针对早期精神病的综合认知康复计划在协调专科护理（CSC）中的实施情况，并调查该干预措施在CSC环境中是否可持续。使用关于接受治疗的患者数量、培训的促进者、开展的小组以及资金的数据来评估可持续性。结果表明，自2016年首次实施以来，该干预措施已作为标准护理的一部分常规可用，已有100多名患者接受了治疗。该报告讨论了该计划成功实施的关键因素。
