Birth Order and Sibling Gender Rati

Birth Order and Sibling Gender Ratio of a Clinical Sample

209 Iranian J Psychiatry 9:4, October 2014 ijps.tums.ac.ir

Original Article
The Effectiveness of Computerized Cognitive Rehabilitation Training Program in Improving Cognitive Abilities of Schizophrenia Clients

Mohammad Reza Mohammadi, MD1
Zahra Keshavarzi, MSc2
Siavash Talepasand, PhD3
1 Psychiatric and Psychology Research Center, Department of Psychiatriy and Psychology, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran 2 Mental Health Clinic, 372, Dastgerdi (Zafar) Street, Valie Asr Ave., Tehran, Iran 3 Department of Psychiatry, Faculty of Psychology & Educational Sciences, Semnan University, Semnan, Iran
Corresponding author:
Zahra keshavarzi, MSc
Mental Health Clinic, 372, Dastgerdi (Zafar) Street,Valie Asr Ave.,Tehran,Iran.
Tel:[phone]
Fax: [phone]
Email: [e-mail]
Iran J Psychiatry 2014; 9:4: 209-215
Objective: The aim of this study was to evaluate the efficacy of a computer – based training program of attention, memory and executive functions in enhancing neuropsychological performances as well as functional outcome in clients with schizophrenia .
Method: A total of 15 clinically stable out patients with Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria for schizophrenia, diagnosed with different types of schizophrenia: paranoid, disorganized, residual, based on DSM- IV-TR were selected to participate in this study. All patients were randomly selected using a conventional sampling method and assigned to 60 hours individual sessions of computer – assisted cognitive remediation (CACR).This was a pre- experimental study with pretest and posttest in a single group. Cognitive functions were checked with Continuous Performance Test (CPT), Wechsler Adult Intelligence Scale (Wds) and Prospective and Retrospective Memory Questionnaire (PRMQ). The symptoms of patients were measured with the Positive and Negative Syndrome Scale (PANSS). Remediation was performed utilizing the Rehacome® software. Patients received the cognitive remediation program including attention, concentration and working memory. All participants were followed up after an interval of one month and three months. Data were analyzed using repeated measures analysis.
Result: After 3 months, the findings showed that patients’ scores improved in the time factor. Also, a significant improvement favoring cognitive remediation was found in several cognitive measures including Reaction Time (F = 4015p

Results (Indonesian) 1:

Birth Order and Sibling Gender Ratio of a Clinical Sample 209 Iranian J Psychiatry 9:4, October 2014 ijps.tums.ac.ir Original Article The Effectiveness of Computerized Cognitive Rehabilitation Training Program in Improving Cognitive Abilities of Schizophrenia Clients Mohammad Reza Mohammadi, MD1Zahra Keshavarzi, MSc2Siavash Talepasand, PhD31 Psychiatric and Psychology Research Center, Department of Psychiatriy and Psychology, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran 2 Mental Health Clinic, 372, Dastgerdi (Zafar) Street, Valie Asr Ave., Tehran, Iran 3 Department of Psychiatry, Faculty of Psychology & Educational Sciences, Semnan University, Semnan, Iran Corresponding author: Zahra keshavarzi, MSc Mental Health Clinic, 372, Dastgerdi (Zafar) Street,Valie Asr Ave.,Tehran,Iran. Tel:[phone] Fax: [phone] Email: [e-mail] Iran J Psychiatry 2014; 9:4: 209-215 Objective: The aim of this study was to evaluate the efficacy of a computer – based training program of attention, memory and executive functions in enhancing neuropsychological performances as well as functional outcome in clients with schizophrenia . Method: A total of 15 clinically stable out patients with Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria for schizophrenia, diagnosed with different types of schizophrenia: paranoid, disorganized, residual, based on DSM- IV-TR were selected to participate in this study. All patients were randomly selected using a conventional sampling method and assigned to 60 hours individual sessions of computer – assisted cognitive remediation (CACR).This was a pre- experimental study with pretest and posttest in a single group. Cognitive functions were checked with Continuous Performance Test (CPT), Wechsler Adult Intelligence Scale (Wds) and Prospective and Retrospective Memory Questionnaire (PRMQ). The symptoms of patients were measured with the Positive and Negative Syndrome Scale (PANSS). Remediation was performed utilizing the Rehacome® software. Patients received the cognitive remediation program including attention, concentration and working memory. All participants were followed up after an interval of one month and three months. Data were analyzed using repeated measures analysis. Result: After 3 months, the findings showed that patients’ scores improved in the time factor. Also, a significant improvement favoring cognitive remediation was found in several cognitive measures including Reaction Time (F = 4015p<.05, Eta = 0.242), Wds (F = 11.806, p<.05,Eta = .48) PRMQ1(F = 3.314, p<.05, Eta = 0.20) PRMQ7(F = 2.85, p<.05, Eta = 0.18). Kesimpulan: Program pelatihan komputer-dibantu kognitif remediasi adalah efektif dalam meningkatkan kinerja pasien penderita skizofrenia. CACR tidak memiliki efek pada gejala positif dan negatif. Studi lanjutan jangka panjang diperlukan untuk mengkonfirmasi pemeliharaan perbaikan tersebut. Kata kunci: Berbantuan komputer perbaikan kognitif, skizofrenia, Rehacom Software dan fungsi eksekutifSkizofrenia adalah neurobiologicaldisorder menghancurkan yang biasanya menyerang fungsi otak remaja dan dewasa muda, terjadi di sekitar 1 dari setiap 100 orang di seluruh dunia (1,2). Patofisiologi skizofrenia masih membingungkan (3, 4). Selama 30 tahun terakhir, besar kemajuan telah dibuat dalam pemahaman kita tentang neurobiologi dan pengobatan skizofrenia, dan kemajuan tersebut telah disertai dengan peningkatan keseluruhan yang sederhana hasil (5, 2). Kognitif gangguan yang umum, kronis melumpuhkan fitur skizofrenia (6). Defisit dalam kognitif berfungsi, termasuk dalam kecepatan psikomotor, perhatian, memori dan fungsi eksekutif yang berpikir untuk menggarisbawahi parah Cacat fungsional yang terkait dengan penyakit ini (7, 8, 9, 10, 11). Selain itu, sejumlah penelitian telah menunjukkan hasil yang fungsional. Banyak pendekatan yang telah dikembangkan dalam lima belas tahun terakhir seperti berbantuan komputer perbaikan kognitif (CACR). Skizofrenia menunjukkan beberapa penurunan pada ukuran neurokognitif berfungsi dalam perhatian, verbal dan bekerja memori dan fungsi eksekutif (12, 13, 14, 15). Beberapa studi telah menunjukkan peningkatan kognitif yang signifikan atas berbagai kompetensi (16, 17,18,19,20,35,36 dan 37) sedangkan beberapa studi menunjukkan heterogen kesimpulan tentang perbaikan yang dihasilkan dari Mohammadi, Keshavarzi, Talepasand Iran J psikiatri 9:4, ijps.tums.ac.ir Oktober 2014 210 CACR (21, 22). Dalam beberapa dekade terakhir, beberapa teknik perbaikan kognitif (komputerisasi dan terkomputerisasi bebas) telah dirancang untuk kedua individu dan kelompok pengaturan. Intervensi CACR tampak sangat relevan dalam skizofrenia, dimana neurokognitif perubahan menyerap semua kemampuan domain dan mempengaruhi kualitas hidup pasien. Wykes dan Vander Gaag (23) menjelaskan "perbaikan kognitif" sebagai satu set metode untuk mengajar "berpikir skill" yang berfokus pada defisit kognitif dan gelar sebagai karakteristik umum ketergantungan pada bahan yang memiliki relevansi tidak pribadi individu. MC Guurk. dan et al. (24) telah melaporkan efektivitas remediasi kognitif pada skizofrenia dan peningkatan fungsi psikologis. Selain itu, CACR juga diterima diantara pasien, dan dalam beberapa tahun terakhir banyak penelitian telah dilakukan berdasarkan CACR untuk meningkatkan hasil fungsionalnya pada pasien penderita skizofrenia. The Rehacom system (Hasomed GmbH, Germany) increases the capacity and efficiency of cognitive function and may be useful in improving cognitive disorders in patients with schizophrenia (35, 36, 37). This program has shown positive results in cognitive functions, in the ability to solve interpersonal problems and in autonomy and symptoms (25). Several studies showed a significant cognitive enhancement over various competencies. Benedict et al. (26) reported the effectiveness of cognitive – behavioral intervention in 15 clients with cognitive impairment associated with behavioral changes. In a randomized study, patients were randomly assigned to receive neuropsychological counseling or psychotherapy. After 2 weeks, the subjects of the active treatment group showed significant improvements in socially aggressive behavior compared to patients assigned to standard psychological counseling. Amato et al. (27) randomized 39 patients with schizophrenia to either 112 hours individual sessions of computer – assisted cognitive remediation or a control condition. The results showed that cognitive performances concerning attention / vigilance, verbal working memory and verbal learning memory and reasoning / problem solving improved significantly in the remediation condition while no differences were reported in the control condition between the 2 groups. However, no significant benefits of cognitive remediation were observed in non – verbal working memory and learning, speed of processing or functional outcome measures. Moreover, a number of studies have demonstrated that CACR may also affect psychotic symptoms and solve interpersonal problems in autonomy and symptoms. Taking into account all these factors, we assumed that offering computer – assisted cognitive remediation program to patients with schizophrenia could improve cognitive functioning. The present study investigated the effectiveness of computerized cognitive rehabilitation in improving cognitive abilities of schizophrenic patients. Material and Methods Clinical Trial Design This was a pre-experimental study with pretest and posttest in a single group. The participants were assigned to receive CACR. Cognitive assessments were done four times for the patients at the beginning and at the end of the study. All participants were followed up after an interval of one month and three months. The assessment was conducted by a psychologist who was blind to the treatment assignment. Participants The participants were recruited by a conventional sampling method and were enrolled in the study from November 2011 to April 2012. A total of 15 clinically stable out patients with (DSM-IV-TR) criteria for schizophrenia signed the consent form and completed the baseline evaluation. The inclusion criterion for the study participants was the age of 18 or older. Diagnosis was made by expert clinicians through chart review and clinical interview using a symptom checklist allowing (DSM-IV-TR) criteria to be applied. Exclusion criteria were substance abuse or dependency during the previous 6 months, and having one or more clinical psychiatric disorders. Those participants who had acute medical diseases were removed from the study. Assessment Symptoms Psychiatric symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS) (28). The symptoms were assessed following a semi- structured interview, referring to the month before the evaluation by the raters who used the scale routinely. Inter-rater reliability was measured and found to be high (intraclass correlation coefficient >0.9 for PANSS total scores). Inter –rater reliability of PANSS total scores and item scores were fairly good, with kappa scores between 0.60 and 0.70. PANSS items were divided into five factors according to (29): positive, negative, depressive, cognitive and excitement / hostility. Neuropsychological Assessment We used the Continuous Performance Test Identical Pair Version (CPTIP) to measure attention and vigilance. This requires the subject to respond whenever two identical stimuli appear in a row within a sequence of 150 rapidly flashed trials. We used the two– digit version and the 4 – digit version. We retained (14) the index of perceptual sensitivity to signal the noise differences [d index] and (2) the response criterion; i.e., the amount of perceptual evidence that the subject required to decide whether a stimulus is a target [natural log of beta]. A valid CPTIP test was defined as a “d’index” greater than