Targeted cognitive training improves auditory and verbal outcomes among treatment refractory schizophrenia patients mandated to residential care

SCHIZOPHRENIA RESEARCH

卷:202

Article

Thomas, Michael L.^1,2  Bismark, Andrew W.^1,2  Joshi, Yash B.^1,2  Tarasenko, Melissa^1,2  Treichller, Emily B. H.^1,2  Hochberger, William C.^1,2  Zhang, Wen³  Nungaray, John¹  Sprock, Joyce^1,2  Cardoso, Lauren^1,4  Tiernan, Kristine⁴  Attarha, Mouna⁵  Braff, David L.^1,2  Vinogradov, Sophia⁶  Swerdlow, Neal^1,2  Light, Gregory A.^1,2,3 

[1] Univ Calif San Diego, Dept Psychiat, 9500 Gilman Dr MC 0804, La Jolla, CA 92093 USA

[2] VA San Diego Healthcare Syst, VISN Mental Illness Res Educ & Clin Ctr MIRECC 22, San Diego, CA USA

[3] San Diego State Univ Univ Calif San Diego SDSU UC, San Diego, CA USA

[4] Alpine Special Treatment Ctr Inc, Alpine, CA USA

[5] Posit Sci Corp, 160 Pine St Suite 200, San Francisco, CA 94111 USA

[6] Univ Minnesota, Dept Psychiat, Minneapolis, MN 55455 USA

关键词: Schizophrenia;    Targeted cognitive training;    Cognitive remediation;    Chronic psychosis;    Effectiveness;   

DOI  :  10.1016/j.schres.2018.07.025

来源: Elsevier

【 摘 要 】

Computerized targeted cognitive training (TCT) of auditory processing has been shown to improve verbal learning in several clinical trials of schizophrenia outpatients. Less is known, however, about the effectiveness of this promising intervention in more chronic. treatment-refractory patients who are treated in non-academic settings. This study aimed to determine whether TCT improves auditory processing, verbal learning, and clinical symptoms in SZ patients mandated to receive care at a locked residential rehabilitation center. Secondarily, potential factors that moderate TCT's effectiveness including age, symptom severity, antipsychotic medication load, and duration of illness were examined. Schizophrenia patients were randomized to treatment as usual (TAU; n = 22) or TAU augmented with TCT (TAU + TCT; n = 24). Outcomes included a measure of auditory perception (Word-In-Noise test, WIN), verbal learning domain scores from the MATRICS Consensus Cognitive Battery (MCCB), and clinical symptoms (Scale for the Assessment of Positive Symptoms, SAPS; Scale for the Assessment of Negative Symptoms, SANS). TO produced significant improvements in auditory perception (d = 0.67) and verbal learning (d = 0.65); exploratory analyses revealed a statistically significant reduction in auditory hallucinations (d = -0.64). TCTs effects were only weakly, and mostly non-significantly, moderated by age, clinical symptoms, medication, and illness duration. These findings indicate that even highly symptomatic, functionally disabled patients with chronic illness benefit from this emerging treatment. Ongoing studies will examine the predictive utility of neurophysiological biomarkers and other characteristics assessed at baseline. (C) 2018 Published by Elsevier B.V.

【 授权许可】

Free