Journal

The Japanese journal of neuropsychology

[Vol.26 No.3 contents]
Japanese/English

Full Text of this Article
in Japanese PDF (289K)
ArticleTitle Cognitive rehabilitation for schizophrenia
Language J
AuthorList Emi Ikebuchi
Affiliation Department of Psychiatry, Teikyo University School of Medicine
Publication Japanese Journal of Neuropsychology: 26 (3), 196-203, 2010
Received
Accepted
Abstract Persons with schizophrenia have profoundly affected social functioning, which are partially attributed to cognitive functioning such as memory, attention, learning, and executive functioning. The aim of cognitive rehabilitation for schizophrenia is improving cognitive functioning per se, or learning compensating strategies for disabled functioning. Meta-analyses of previous researches show effect size of cognitive rehabilitation ranging from 0.3 to 0.9, and the effects for social functioning and psychiatric symptoms are modest. There remains much room to be studied about theories and methodologies of cognitive rehabilitation when considering characteristics and etiology of cognitive dysfunction of schizophrenia. Although theoretical base is immature, we think it is possible to improve cognitive functioning using intervention technologies of psychiatric rehabilitation, cognitive behavior therapy, learning theory, and intervention for brain injury. Cognitive rehabilitation of our Day Treatment Center at the Teikyo University Hospital and other 3 cooperating sites was based on NEAR (Neuro-psychologial Educational Approach to Cognitive Remediation, Medalia et al. 2002), and the results were reported. Thirty two out-patients diagnosed with schizophrenia or schizo-affective disorder were randomly assigned to cognitive rehabilitation and day treatment (CR group), or day treatment only (control group). CR group was received biweekly 19 hour computer training and weekly 10 hour bridging group sessions which aimed to help participants to realize relationship social functioning and cognitive functioning, to generalize the effects of computer training, and to make insight into patterns of cognitive functioning (meta-cognition). CR group was significantly improved at the composite score of the Brief Assessment of Cognition in Schizophrenia (BACS-J, Keefe et al, 2008) analyzing with two-way ANOVA. Social skills assessment also show more improving in CR group (p<0.1) than control group. Two cases are reported. One case with severe negative symptoms and moderate positive symptoms improved her cognitive functioning measured with BACS-J, and her activities at the Day Treatment Center were also improved. Although another case had good cognitive functioning, she had tendency to be confused and did to behave effectively when feeling anxiety. After NEAR she got insight about her tendency and coping skills, and she could enter into vocational training.
Keywords cognitive rehabilitation, cognitive behavior therapy, schizophrenia, psychiatric rehabilitation, supportive empolyment

Copyright © 2002 NEUROPSYCHOLOGY ASSOCIATION OF JAPAN All rights reserved
http://www.neuropsychology.gr.jp/