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Compensatory cognitive training for psychosis: Effects in a randomized controlled trial

机译:精神病的补偿性认知训练:在随机对照试验中的作用

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Objective: Treatments for the cognitive impairments of schizophrenia are urgently needed. We developed and tested a 12-week, group-based, manualized, compensatory cognitive training intervention targeting prospective memory, attention, learning/memory, and executive functioning. The intervention focused on compensatory strategies, such as calendar use, self-talk, note taking, and a 6-step problem-solving method, and did not require computers. Method: In a randomized controlled trial, 69 outpatients with DSM-IV primary psychotic disorders were assigned to receive standard pharmacotherapy alone or compensatory cognitive training + standard pharmacotherapy for 12 weeks. Assessments of neuropsychological performance and functional capacity (primary outcomes) and psychiatric symptom severity, quality of life, social skills performance, cognitive insight, and self-reported everyday functioning (secondary outcomes) were administered at baseline, posttreatment, and 3-month follow-up. Data were collected between September 2003 and August 2009. Results: Hierarchical linear modeling analyses demonstrated significant compensatory cognitive training-associated effects on attention at follow-up (P = .049), verbal memory at posttreatment and follow-up (P values ≤ .039), and functional capacity (University of California, San Diego Performance-based Skills Assessment) at follow-up (P = .004). The compensatory cognitive training group also differentially improved in negative symptom severity at posttreatment and follow-up (P values ≤ .025) and subjective quality of life at follow-up (P = .002). Conclusions: Compensatory cognitive training, a low-tech, brief intervention, has the potential to improve not only cognitive performance but also functional skills, negative symptoms, and self-rated quality of life in people with psychosis. Trial Registration: ClinicalTrials.gov identifier: NCT01521026.
机译:目的:急需治疗精神分裂症的认知障碍。我们开发并测试了一个为期12周的,基于小组的,手动的,有偿的认知训练干预措施,其针对前瞻性记忆,注意力,学习/记忆和执行功能。干预的重点是补偿性策略,例如日历使用,自言自语,笔记记录和六步解决问题的方法,并且不需要计算机。方法:在一项随机对照试验中,将69名患有DSM-IV原发性精神病的门诊患者单独接受标准药物治疗或进行补偿性认知训练+标准药物治疗12周。在基线,治疗后和3个月随访中对神经心理学表现和功能能力(主要结局),精神症状严重程度,生活质量,社交技能表现,认知能力和自我报告的日常功能(次要结局)进行评估。向上。在2003年9月至2009年8月之间收集了数据。结果:分层线性建模分析表明,在随访时(P = .049),治疗后和随访时的言语记忆(P值≤)具有明显的补偿性认知训练相关效应。 039),以及随访时的功能能力(加州大学圣地亚哥分校基于绩效的技能评估)(P = .004)。补偿性认知训练组在治疗后和随访时的阴性症状严重程度(P值≤.025)和随访时的主观生活质量(P = 0.002)上也有不同的改善。结论:补偿性认知训练是一项技术含量低,简短的干预措施,不仅可以改善认知能力,而且还可以改善精神病患者的功能技能,消极症状和自我评估的生活质量。试验注册:ClinicalTrials.gov标识符:NCT01521026。

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