Effects Of Computer Cognitive Remediation Therapy For Cognitive Function In Patients With Schizophrenia

Objective:To evaluate the efficiency of computer cognitive remediationtherapy (CCRT) on improving the cognitive function in patients withschizophrenia.Methods: A total of48patients with chronic schizophrenia wererecruited from The First Hospital of Hebei Medical University, from06.2010to06.2011. All according with the diagnosis standard of schizophrenic byDiagnostic and Statistical Manual of Mental Disorders-Ⅳ(DSM-Ⅳ); aged18to45years; duration over2years; All the patients are in stable condition, inresidual or partial remission, the curative effect of drug treatment was stableand unvaried, informed consents were obtained from the subjects. All patientswere divided into computer cognitive remediation group(CCRTG) and controlgroup (CG) at random(n=24). In the similar drug treatment, the CCRT grouppatients received cognitive exercises instructed by therapist on the computerswith system of cognitive remediation, which included three models: cognitiveflexibility, working memory and planning execution. In control group, thesubjects received Antipsychotics only, Pre-and post-treatment, positive andnegative syndrome scale(PANSS), Wisconsin Card Sorting Test(WCST) andBrief Assessment of Cognitive in Schizophrenia (BACS) were assessed to allsubjects.Results:Totally48schizophrenia patients were involved in the study,after6week's treatment,24ones in CCRT group and23ones in control groupentered the result analysis,except one lost.①Compared with beforethetreatment,a significant decrease occurred in PANSS total score, positivesymptom score,negative symptom score,and general psychopathology score inboth groups(t=2.62~10.08,P<0.05); Between the two groups, the decease ofthe negative symptoms scale was significant difference(t=2.76,P=0.008<0.05), the decrease of the other two items between the two groups were notobvious(P>0.05).②C ompared with beforethe treatment,a significant changeoccurred in both groups on score of BACS and WCST(t=1.42~6.95,P<0.05)(t=2.48~9.13,P<0.05);between the two groups,the difference of tests of simpledigital sequence (DS) test scores was significant(F=4.374,P=0.042<0.05),thedifference of the remaining items on the score between the two groups was nosignificant(P>0.05);The difference of the Wisconsin Card Sorting Test Repeaterrors (Rpe) test scores between the two groups on the rise is significant(F=4.172,P=0.047<0.05),the difference of the remaining items on the scorebetween the two groups was significant(P>0.05).③The scales of the PANSSand the BACS were improvement in both groups, but there are no significantcorrelation between them(P>0.05).After12week's treatment,23ones in CCRTgroup and22ones in control group entered the result analysis,except2oneslost. All the scores of the BACS and WCST in both groups have improved,butonly the sequence of digital sequence(DS), verbal memory (VM),Tower ofLondon test (TOL), Response amount(Ra) and Repeat errors(Rpe) havesignificant correlation to the treatment duration (P<0.05); Compared with thecontrol group, the CCRT group have better cognition, Especially the TOL testimproved significantly(P<0.05),and a significant decrease occurred in (Rpe)test(P<0.05); The other items were no significant difference between the twogroups(P>0.05).Conclusion: CCRT can improve the cognitive function of patients withschizophrenia to some extent,the effect is related to the treatment duration, andthe repeated measure ANOVA showed a significant time×treatment. but nosignificant improvement in positive symptoms.