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. Bahan dan metode Desain percobaan klinis Ini adalah studi pra-eksperimental pretest dengan posttest dalam satu kelompok. Peserta ditugaskan untuk menerima CACR. Penilaian kognitif telah dilakukan empat kali untuk pasien di awal dan di akhir studi. Semua peserta akan ditindaklanjuti setelah selang waktu satu bulan dan tiga bulan. Penilaian dilakukan oleh seorang psikolog yang buta untuk penetapan pengobatan. Peserta Para peserta direkrut oleh metode sampling konvensional dan terdaftar dalam studi dari November 2011 hingga April 2012. Total 15 klinis stabil keluar pasien dengan kriteria (DSM-IV-TR) untuk skizofrenia menandatangani formulir izin dan menyelesaikan evaluasi dasar. Kriteria inklusi untuk peserta penelitian pada usia 18 tahun atau lebih. Diagnosis dibuat oleh dokter ahli melalui grafik Tinjauan dan klinis wawancara menggunakan daftar gejala memungkinkan kriteria (DSM-IV-TR) harus diterapkan. Kriteria pengecualian adalah substansi penyalahgunaan atau ketergantungan selama 6 bulan sebelumnya, dan memiliki satu atau lebih gangguan kejiwaan klinis. Peserta yang memiliki penyakit akut medis telah disingkirkan dari studi. Penilaian gejala Gejala psikiatris dinilai dengan positif dan negatif sindrom skala (PANSS) (28). Gejala dinilai mengikuti semi - terstruktur wawancara, merujuk kepada bulan sebelum evaluasi oleh penilai yang digunakan skala secara rutin. Reliabilitas rating antar diukur dan menemukan tinggi (intraclass korelasi koefisien > 0,9 untuk PANSS jumlah nilai). Inter-keandalan rating total nilai PANSS dan nilai barang yang cukup baik, dengan Skor kappa antara 0,60 dan 0,70. PANSS item dibagi menjadi lima faktor menurut (29): positif, negatif, depresi, kognitif dan kegembiraan / permusuhan. Penilaian neuropsychological Kami digunakan terus-menerus kinerja tes identik Pair versi (CPTIP) untuk mengukur perhatian dan kewaspadaan. Hal ini memerlukan subjek untuk menjawab setiap kali dua identik rangsangan muncul dalam satu baris dalam urutan uji cepat flashed 150. Kami menggunakan versi dua-digit dan 4-digit versi. Kami mempertahankan (14) indeks persepsi kepekaan terhadap sinyal perbedaan suara [d indeks] dan (2) kriteria respon; yaitu, jumlah persepsi bukti bahwa subjek harus memutuskan apakah rangsangan target [alami log beta]. Tes CPTIP berlaku didefinisikan sebagai "d'index" lebih besar dari