ABSTRACT
Introduction: The differences in the scores observed in the attention, memory and executive functions regarding the use of a cognitive rehabilitation program in patients with long-standing schizophrenia are analysed. Method: The participants were selected through a nonprobability sampling with a purposive sample ofcritical cases (n = 31). It is a causal research, which considers a quasi-experimental design of two groups (experimental and control) with pre and postintervention measures. To measure the variables, the TMTA & B, WAIS, ROCF and the Stroop P & C tests were administered. Results: The intervention had a clinically significant impact on the domains of visual spatial attention and the executive function (speed of verbal information processing), given by the differences caused by the post-intervention means. There were only statistically significant differences of means in the post-test scores for the Rey-Osterrieth complex figure test, in the Memory-Time variable, whose treatment has a low impact and false negative rates higher than initially expected. At the same time, regarding the variability of the scores, there were not statistically significant differences for any of the variables analysed. Conclusions: Training the identification of symbols, using memories of details of projected images and simple words association, in a group-competition context with playful elements, have a clinically relevant impact on the rehabilitation of the visual spatial attention and the speed of verbal information processing of patients with long-standing schizophrenia. The statistically significant differences of means require to be considered with care.
Introducción: Se analizan las diferencias en las puntuaciones observadas en atención, memoria y función ejecutiva en función de un programa de rehabilitación cognitiva en pacientes con esquizofrenia de larga data. Método: Los participantes fueron seleccionados mediante un muestreo noprobabilístico con una muestra intencional de casos críticos (n = 31). Investigación explicativa, con diseño cuasi experimental de dos grupos (experimental y control) y medidas pre y post intervención. Para medir las variables se administraron los test TMT A y B, WAIS, F.C. de Rey, STROOP P y C. Resultados: La intervención tuvo un impacto clínicamente significativo en el Dominio de la Atención focalizada visual y en el Dominio Ejecutivo (velocidad de procesamiento de información verbal) dado por las diferencias de medias post intervención. Sólo existieron diferencias de medias estadísticamente significativas en los puntajes post test para la Figura Compleja de Rey en la variable Memoria-Tiempo, cuyo tratamiento tiene un impacto bajo y tasas de falsos negativos superiores a las esperadas. A su vez, respecto a la variabilidad de las puntuaciones, no se observaron diferencias estadísticamente significativas para ninguna de las variables analizadas. Conclusiones: Entrenar identificando símbolos, recuerdos de detalles de imágenes proyectadas, asociación de palabras simples, en contextos de competición entre grupo con elementos lúdicos, tiene un impacto clínicamente relevante en la rehabilitación de la atención focalizada visual y en la velocidad de procesamiento de información verbal en sujetos con esquizofrenia de larga data. Las diferencias de medias estadísticamente significativas detectadas requerirían ser consideradas con precaución.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Attention/physiology , Cognitive Behavioral Therapy/methods , Executive Function , Memory/physiology , Schizophrenia/rehabilitationABSTRACT
A thematic review of research in cognitive reabilitation of patients with schizophrenia is presented with the purpose of systematizing a contribution to the generation of intervention proposals for early stages of the disorder. Sudies are reviewed between 2004-2013 based on the "PubMed.gov" and "Scielo.org" search engines. Forty-two papers were found and 19 were selected, applying as inclusion criteria research with control groups that show positive results in the rehabilitation of attention, memory, and executive function. Furthermore, the aim is to get to know the cognitive rehabilitation program on which that research is based in order to appreciate its approach and its emphases. The results show a corpus of interventions which, in spite of their diversity, have a significant impact on the patients' cognitive and psychosocial functioning. The main predictors of good results are low age, low degree of cognitive deterioration, and low use of antipsychotic medication at the time of intervention. Improvement of executive functioning appears to be the best predictor of the patients' functionality in everyday activities. An impact is also seen of cognitive improvement on relevant clinical indicators: functioning in everyday activities, social adjustment, and clinical indices associated with a decrease of the observed symptoms. It is concluded that these results, together with research in which it is estimated that the alteration of the course of the schizophrenia requires early and multimodal work, imply the need to generate therapeutic proposals from the first episodes where the cognitive rehabilitation of the patient cannot be absent.
Subject(s)
Humans , Rehabilitation , Schizophrenia , Social Adjustment , Therapeutics , Executive FunctionABSTRACT
Introducción: Se analiza la relación entre las estrategias y estilos de aprontamiento de padres, frente a los primeros brotes psicóticos de sus hijos adolescentes, y la adherencia a tratamiento de estos jóvenes. Método: Estudio correlacional, cuya muestra fue construida de manera probabilística, al azar simple y constituida por 23 jóvenes con uno de sus respectivos progenitores. Estos jóvenes se mantienen en tratamiento en un Servicios de Psiquiatría de la Salud Pública Chilena. Resultados: Los padres en su mayoría, utilizan estrategias y estilos de afrontamiento empleando un Método de tipo Activo, controlando la respuesta Emocional generada por el problema y movilizando fundamentalmente una actividad de tipo Cognitiva. Se observa que el grupo con adherencia a tratamiento presenta mayores puntajes de manera estadísticamente significativa respecto de la Estrategia Planificación. Por su parte el grupo sin adherencia a tratamiento presenta mayores puntajes en cuanto a la Estrategia Evitar el Afrontamiento. Conclusiones: Una aproximación activa, analítica y racional del problema por parte de los padres, se correlaciona con la adherencia a tratamiento de sus hijos
Introduction: This paper analyses the relationship between the strategies and styles used by parents to deal with teenagers children showing early symptoms of a psychotic condition and these youngsters adherence to treatment. Methods: This is a co-relational study based on a sample built on probabilistic, random basis and made up by 23 youngsters accompanied by one of their parents. These youngsters are all being treated in one of the psychiatric units of the Chilean public health service. Results: The results indicate that parents, by and large, use an active method, trying to control emotions and setting in motion cognitive activity. The study shows that the group adhering to treatment presents significantly higher scores, in statistical terms, in favour of a planning strategy. On the other hand, the group with no adherence to treatment presents a higher score in favour of an avoid-to-face strategy. Conclusion: Parents, by and large, use an active method, with analytical and rational activity correlated to the adherence of the youngsters to treatment