Abstract
Zusammenfassung.Theoretischer Hintergrund: Kognitive Funktionseinschränkungen sind zentrales Merkmal schizophrener Erkrankungen und werden entsprechend im Behandlungskonzept berücksichtigt. Kognitive Remediationsprogramme gelten als wirksam, Effektstärken als moderat. Trainingsvarianten werden zur Effektoptimierung erprobt. Fragestellung: Ist gezieltes Funktionstraining in neuroplastizitäts-orientiertem Lernkontext effektiver als breitgefächertes Behandlungsprogramm und werden Effekte durch das Erkrankungsstadium moduliert? Methode: Bei 59 chronisch und 31 ersthospitalisierten schizophren Erkrankten wurden kognitive Defizite über Testleistungen der MATRICS Consensus Cognitive Test Battery gegenüber 25 gesunder Kontrollpersonen erfasst. Testleistungen vor, nach 4-wöchiger Interventionsphase mit zwei spezifischen Trainings oder Standardbehandlung und 3-monatiger Katamnese prüften den Einfluss von Interventionstypus und Erkrankungsstadium auf Leistungsverbesserung. Ergebnisse: Sowohl chronische wie erstmals behandelte Patienten aller Behandlungsgruppen verbesserten sich signifikant über die Messzeitpunkte, obwohl Defizite relativ zu Kontrollen fortbestanden. Schlussfolgerungen: Spezifisches Training verbessert kognitive Funktionen nicht über Zeit/Remissionseffekte hinaus.
Abstract.Background: Cognitive impairment is a core feature of schizophrenia targeted with remediation strategies. While deficits respond to cognitive remediation, moderate effect sizes motivate the study of training variants for effect amplification. Objective: Does targeted neuroplasticity-based training improve cognitive deficits more than nonspecific remediation (in)dependently of early/chronic stages of the illness? Method: Cognitive deficits in 59 chronic and 31 newly admitted patients were determined relative to 25 healthy controls with the MATRICS Consensus Cognitive Battery. Patients’ performance was assessed before, after two 4-week long targeted neuroplasticity-based training protocols or treatment-as-usual, and at a 3-month follow-up. Results: Performance improved across assessments independently of intervention type, phase of illness, or symptom remission test, not reaching normal levels, however. Conclusion: Short-term improvement of cognitive deficits is independent of treatment variant and phase of illness. Factors augmenting remediation effects beyond targeting function and neuroplasticity-based learning remain to be scrutinized.
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