Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel.
Department of Community Mental Health, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel.
BMC Psychiatry. 2023 Jan 17;23(1):42. doi: 10.1186/s12888-022-04510-0.
Literature explains participation limitations among people with schizophrenia through the context of metacognitive limitations, specifically in symptoms and in executive functions (EF). Research has shown mixed results regarding associations between symptoms and participation, reporting association with negative symptoms, positive symptoms, or only metacognitive limitations. The aim of this study was to deepen understanding of the symptoms' impact on the association between participation and executive function among people with schizophrenia.
Forty-three participants with schizophrenia received 8 group sessions of focused metacognitive intervention (MCG) aimed at promoting participation by focusing on EF components (e.g., analyzing individual cognitive strategy use). Three measures were administered: the Positive and Negative Syndrome Scale (PANSS) to evaluate symptoms, the Weekly Calendar Planning Assessment (WCPA) to assess EF, and the Activity Card Sort (ACS) to measure participation at the baseline and 12 weeks following completion of the intervention. Scores were compared to a matched control group of 41 people with schizophrenia who instead received treatment as usual. The role of PANSS as moderator was examined using multiple hierarchical regressions, entering interactions between the PANSS scores and WCPA change scores in the final regression step.
Relationships were not significant for participants with high PANSS scores. A positive relationship existed between change in WCPA and change in ACS for participants with low PANSS scores.
These results demonstrate that low PANSS scores moderate the association between EF and participation and highlight the importance of symptoms as a predictor of participation following the MCG intervention.
The trial was retrospectively registered at clinical.
gov.
gov Identifier: NCT05556941. Clinicaltrial.gov registration date: 27/09/2022.
文献通过元认知限制的背景解释了精神分裂症患者的参与限制，特别是在症状和执行功能（EF）方面。研究表明，症状与参与之间的关联结果喜忧参半，报告与阴性症状、阳性症状或仅与元认知限制有关。本研究旨在深入了解症状对精神分裂症患者参与和执行功能之间关联的影响。
43 名精神分裂症患者接受了 8 次集中的元认知干预（MCG）小组会议，旨在通过专注于 EF 成分（例如，分析个人认知策略的使用）来促进参与。共进行了三项测量：阳性和阴性症状量表（PANSS）评估症状、每周日程规划评估（WCPA）评估 EF 以及活动卡片分类（ACS）评估基线和干预完成后 12 周的参与情况。将评分与 41 名接受常规治疗的精神分裂症对照组进行比较。使用多元层次回归检验 PANSS 作为调节者的作用，在最后回归步骤中输入 PANSS 评分与 WCPA 变化评分之间的交互作用。
高 PANSS 评分患者的相关性不显著。低 PANSS 评分患者的 WCPA 变化与 ACS 变化之间存在正相关关系。
这些结果表明，低 PANSS 评分调节了 EF 和参与之间的关联，并强调了症状作为 MCG 干预后参与预测的重要性。
该试验在临床.
trial.gov 上进行了回顾性注册。
CLINICALTRIALS.gov 标识符：NCT05556941。clinicaltrial.gov 注册日期：2022 年 9 月 27 日。
