The efficacy of computerized cognitive drill and practice training for patients with a schizophrenia-spectrum disorder: A meta-analysis

SCHIZOPHRENIA RESEARCH

卷:204

Article

Prikke, Merel¹  Konings, Mette J.²  Lei, Wan U.¹  Begemann, Marieke J. H.¹  Sommer, Iris E. C.³ 

[1] Univ Med Ctr Utrecht, Brain Ctr Rudolf Magnus, Heidelberglaan 100, NL-3584 CX Utrecht, Netherlands

[2] Maastricht Univ, Fac Hlth Med & Life Sci, Dept Med, Maastricht, Netherlands

[3] Univ Groningen, Univ Med Ctr Groningen, Dept Psychiat, Dept Neurosci, Groningen, Netherlands

关键词: Schizophrenia;    Cognitive remediation;    Cognition;    Drill-and-practice;    Meta-analysis;   

DOI  :  10.1016/j.schres.2018.07.034

来源: Elsevier

【 摘 要 】

Background: Computerized methods for improving cognitive functioning in schizophrenia have gained popularity during the past decades. Therefore, this study evaluates the available evidence for the efficacy of computerized cognitive drill and practice training for patients with schizophrenia-spectrum disorders. Methods: A systematic search was carried out using PubMed, Embase, Cochrane Database of Systematic Reviews, and PsycINFO. A meta-analysis was performed to compare cognitive drill and practice training in patients with a schizophrenia-spectrum disorder with non-cognitively oriented control conditions. The primary outcome was cognitive functioning. Secondary outcome measures included psychotic symptoms, depressive symptoms, and functional outcomes. Effect sizes (ES) for all included studies were calculated as Hedges' g. Results: 24 studies were included with 1262 patients in total. Compared to a control condition, patients receiving computerized cognitive drill and practice training showed significantly more improvement on attention (ES = 0.31, p = 0.001), working memory (ES = 0.38, p < 0.001), positive symptoms (ES = 0.31, p = 0.003), and depressive symptoms (ES = 0.37, p= 0.002). Small, marginally significant effect sizes were found for processing speed, verbal and visual learning and memory, and verbal fluency. However, significant effects on functional outcomes and social cognition were absent. Discussion: The current study showed evidence for the efficacy of computerized cognitive drill and practice training in patients with schizophrenia-spectrum disorders. However, the absence of effects on social cognition and functional outcomes questions the generalization of treatment effects. Together, these results stimulate further development of computerized training programs for schizophrenia that not only improve cognitive functioning, but also generalize cognitive improvement to functional outcomes. (C) 2018 Elsevier B.V. All rights reserved.

【 授权许可】

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