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首页> 外文期刊>Journal of the American Academy of Child and Adolescent Psychiatry >Cognitive remediation therapy in adolescents with early-onset schizophrenia: A randomized controlled trial
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Cognitive remediation therapy in adolescents with early-onset schizophrenia: A randomized controlled trial

机译：具有早期精神分裂症的青少年的认知修复治疗：随机对照试验

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Objective Cognitive impairment is an enduring and functionally relevant feature of early-onset schizophrenia (EOS). Cognitive remediation therapy (CRT) improves cognition and functional outcome in adults with schizophrenia, although data in adolescents with EOS remain scarce. The purpose of this study is to examine the efficacy of CRT in improving cognition and functional outcomes in a sample of symptomatically stable but cognitively disabled adolescents with EOS. Method We performed a randomized, controlled trial of individually delivered CRT plus treatment-as-usual compared with treatment-as-usual (TAU). Fifty adolescents with EOS were randomly assigned to receive CRT (n = 25) or TAU (n = 25) and were included in an intention-to-treat analysis. Clinical symptoms and cognitive and functional performance were assessed before and after treatment in both groups and after 3 months in the CRT group. Cognitive domains were defined according to the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) consensus battery and averaged in a global cognitive composite score. Results After CRT, significant improvements were found in verbal memory and executive functions, with medium-to-large effect sizes (ES). The derived cognitive composite score showed an improvement after the treatment, with a large ES. This change was reliable in more than two-thirds of the treated patients. Medium-sized ES were found for improvements after CRT in daily living and adaptive functioning, whereas large ES were observed for improvements in family burden. With the exception of functional gains, these changes were maintained after 3 months. Conclusion CRT appears to be a useful intervention strategy for adolescents with EOS. Cognitive improvements can be achieved through CRT, although further research is warranted to determine the durability of functional gains. Clinical trial registration information - Cognitive Remediation Therapy (CRT) in Adolescents With EOS; www.clinicaltrials.gov; NCT01701609.
机译：客观的认知障碍是早期精神分裂症（EOS）的持久和功能相关的特征。认知修复治疗（CRT）提高了具有精神分裂症的成年人的认知和功能结果，尽管青少年的数据仍然稀缺。本研究的目的是研究CRT在症状稳定但认知的青少年的样本中提高认知和功能结果的疗效。方法我们进行了单独交付的CRT加上治疗的随机，对照试验，与治疗类似（TAU）相比。随机分配50个具有EOS的青少年以接收CRT（n = 25）或TAU（n = 25），并包括在意向治疗分析中。在CRT组中和3个月后，在两组和3个月后进行评估临床症状和认知和功能性能。根据测量和治疗研究定义了认知结构域，以改善精神分裂症（基质）共识电池的认知，并在全球认知综合评分中平均。结果在CRT后，在口头记忆和行政功能中发现了显着的改进，具有中到大的效果大小。衍生的认知综合评分在治疗后显示出改善，具有大的es。这种变化在超过三分之二的治疗患者中是可靠的。在日常生活和适应性运作中CRT后发现中等大小的ES在CRT之后改进，而据观察了大量的es以改善家庭负担。除了功能性收益外，这些变化在3个月后保持。结论CRT似乎是eos青少年的有用干预策略。通过CRT可以实现认知改进，但有必要进一步研究以确定功能性收益的耐用性。临床试验登记信息 - 具有EOS的青少年的认知修复治疗（CRT）; www.clinicaltrials.gov; nct01701609。

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