Bakizadeh Farah, Mokhtari Saba, Saeed Fahime, Mokhtari Asieh, Akbari Koli Pouria, Shalbafan Mohammadreza
Department of Psychology, School of Psychology and Education, University of Tehran, Tehran, Iran.
Department of Psychiatry, School of Behavioral Sciences and Mental Health, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Basic Clin Neurosci. 2024 May-Jun;15(3):287-300. doi: 10.32598/bcn.2022.1604.3. Epub 2024 May 1.
Obsessive-compulsive disorder (OCD) is a disabling mental condition. Many studies have shown that OCD patients have cognitive deficits in various aspects of their cognition, which is a worsening factor of symptom severity, a potential endophenotype, insight predictor, and prognostic indicator of OCD. We designed this systematic review to evaluate the clinical efficacy of cognitive rehabilitation in cognitive deficits and symptom severity of patients with OCD following the PRISMA guidelines.
We searched PubMed, Scopus, ScienceDirect, Google Scholar, and Cochrane Library using the MeSH terms and keywords of 'cognitive rehabilitation' and 'obsessive-compulsive disorder'. The database search identified 200 records of interest, and then 105 duplicates were removed from them. From 95 remaining studies, six articles were eligible for the study and met the inclusion criteria. The six articles described individual RCT studies representing a wide variety of study designs.
The six included studies investigated the effect of "organizational training", "cognitive remediation", "attention splitting" and "goal management training" on cognitive impairments and symptom severity of OCD patients.There are a small number of studies with different designs and some biases that have examined the effectiveness of cognitive rehabilitation in OCD patients, with conflicting results regarding the effect of cognitive rehabilitation on OCD symptom severity or cognitive deficit.
According to the results, we cannot conclude about the efficacy of cognitive rehabilitation in adults with OCD. Considering the importance of cognitive deficits in OCD patients, it is necessary to design and conduct standard trials to investigate the role of cognitive rehabilitation in these disorders.
强迫症(OCD)是一种致残性精神疾病。许多研究表明,强迫症患者在认知的各个方面都存在认知缺陷,这是症状严重程度的一个恶化因素、潜在的内表型、自知力预测指标和强迫症的预后指标。我们按照PRISMA指南设计了这项系统评价,以评估认知康复对强迫症患者认知缺陷和症状严重程度的临床疗效。
我们使用“认知康复”和“强迫症”的医学主题词(MeSH)和关键词在PubMed、Scopus、ScienceDirect、谷歌学术和Cochrane图书馆进行检索。数据库检索共识别出200条感兴趣的记录,随后从中删除了105条重复记录。在剩下的95项研究中,有6篇文章符合纳入标准,可用于本研究。这6篇文章描述了代表各种研究设计的个体随机对照试验(RCT)研究。
纳入的6项研究调查了“组织训练”“认知矫正”“注意力分散”和“目标管理训练”对强迫症患者认知障碍和症状严重程度的影响。有少数设计不同且存在一些偏倚的研究检验了认知康复对强迫症患者的有效性,关于认知康复对强迫症症状严重程度或认知缺陷的影响,结果相互矛盾。
根据研究结果,我们无法得出认知康复对成年强迫症患者疗效的结论。鉴于认知缺陷在强迫症患者中的重要性,有必要设计并开展标准试验来研究认知康复在这些疾病中的作用。