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Integrating psychopharmacology and cognitive remediation to treat cognitive dysfunction in the psychotic disorders

机译：结合心理药理学和认知修复治疗精神病性疾病的认知功能障碍

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Cognitive deficits are a prominent and enduring aspect of schizophrenia, which pose a significant barrier to achieving functional goals. The most promising intervention for treating cognitive impairment is cognitive remediation (CR), a behaviorally based therapy associated with medium effect sizes for cognitive and functional outcomes. However, there is a sizeable group of nonresponders whose CR outcomes become limited when the therapeutic approach fails to address individual differences in baseline cognition, motivation variables, and the extent to which CR offers opportunities for generalization. This speaks to a need to develop cognitive interventions that are both personalized and scalable. Emerging data suggest that specific pharmacological agents have the potential to enhance and accelerate behaviorally based CR effects. This article will review the rationale and preliminary evidence to support combining CR and pharmacotherapy. We will review crucial aspects of cognitive interventions that offer the most promise for improving not only cognitive outcomes, but also for enhancing improvement in real-world functioning. Finally, we will address methodological issues to be considered for future research on combined pharmacological and CR interventions.
机译：认知缺陷是精神分裂症的一个突出且持久的方面，这对实现功能性目标构成了重大障碍。治疗认知障碍最有前途的干预措施是认知补救（CR），这是一种基于行为的疗法，与中等程度的认知和功能结局相关。然而，当治疗方法无法解决基线认知，动机变量以及CR提供推广机会的程度方面的个体差异时，会有相当多的无反应者，其CR结果受限。这表明需要开发个性化且可扩展的认知干预。新兴数据表明，特定的药理作用剂有可能增强和加速基于行为的CR效应。本文将回顾支持CR和药物治疗相结合的基本原理和初步证据。我们将回顾认知干预的关键方面，这些方面不仅有望改善认知结果，而且能够为改善现实世界的功能提供最大的希望。最后，我们将解决在药理学和CR联合干预措施的未来研究中应考虑的方法论问题。

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