RESUMEN
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.
Asunto(s)
Humanos , Rehabilitación , Esquizofrenia , Ajuste Social , Terapéutica , Función EjecutivaRESUMEN
The effectiveness of a Psycho-Educational Workshop oriented to parents with children undergoing first psychotic episodes is evaluated. The Workshop is aimed at promoting strategies for confronting the pathology, reducing stress, anxiety, and depression in the parents, to produce an effect on the treatment of the youngsters. This research was done in the framework of the "Treatment of People from the First Episode of Schizophrenia" Program of Chilean Public health. It is an explicative study based on a pre-experimental design, with pre- and post- intervention measurements with a non-probabilistic and intentional sample of 55 parents distributed randomly in five workshops of 12 sessions each. The results show the use of planned active confrontation strategies, controlling emotion and using preferentially cognitive activity, also achieving decreased anxiety, stress, and depression indicators in the parents. It is concluded that it is important to incorporate the theme of confrontation strategies by the parents in the psychoeducational workshops, particularly in the initial stage of the disorder.
Se evalúa la efectividad de un Taller Psico-Educativo orientado a padres con hijos víctimas de primeros episodios psicóticos. El Taller persigue promocionar estrategias de afrontamiento frente a la patología, reducir estrés, ansiedad y depresión en los padres para incidir en el tratamiento del joven. Investigación realizada en el marco del Programa "Tratamiento de Personas desde el Primer Episodio de Esquizofrenia", de la Salud Pública chilena. Estudio explicativo, en base a un diseño pre-experimental, con medidas pre y post intervención en un grupo. Muestra no probabilística e intencionada de 55 padres, distribuidos aleatoriamente en 5 talleres de 12 sesiones cada uno. Los resultados señalan la utilización de estrategias de afrontamiento activas, planificadas, controlando la emoción y uso de actividad preferentemente cognitiva; además, disminución de la ansiedad, el estrés e indicadores depresivos en los padres. Se concluye en la importancia de incorporar la temática de las estrategias de afrontamiento por parte de los padres en los talleres psicoeducativos, sobre todo en la etapa inicial del trastorno.