dra livia maria mart.. - Departamento de Psiquiatria

Pontes LMM. Attention and memory training in stable schizophrenic patients:
a double-blind, randomized, controlled trial. [dissertation]. São Paulo:
“Faculdade de Medicina, Universidade de São Paulo”; 2011. 269p.
INTRODUCTION: Patients with schizophrenia can have prominent cognitive
deficits, especially in attention, memory and executive functions. Therefore,
this research aimed to propose and assess a low cost attention and memory
cognitive training program, to be delivered in small groups, for Brazilian
patients with schizophrenia. METHOD: Fifty-seven outpatients from two
mental health units, from both genders, with ages between 18 and 50 years
and who fulfilled DSM-IV-R criteria for schizophrenia were invited to
participate in this trial. Subjects were screened based on the type of
medication, history of neurological conditions, abuse or dependency of
psychoactive substances, participation in a cognitive training program in the
last six months, and were assessed for symptoms, intelligence quoeficiente
(I.Q.), attention, memory and quality of life. Seventeen subjects comprised
the final sample and were randomized in two groups: cognitive training or
placebo training. Each intervention was composed of a total of 20 sessions,
which took place along five months. Raters were blind to patients’ condition,
as well as the patients, who did not know to each group they were allocated.
In order to compare groups on baseline, Mann-Whitney test was used to the
continuous variables and qui-squared test was used to the categorical
variables. A nonparametric repeated measures ANOVA was used for
comparisons between groups in different moments (pre and post
intervention). RESULTS: There were no significant differences between
groups in relation to mental health unit to which they had been treated,
gender, age, marital status, schooling, medication, disease duration, number
of hospitalization and I.Q. Groups were also matched at baseline for
symptoms, attention and memory measures, except for long term visual
memory, which was superior in the experimental group. Some differences
were also observed in quality of life, as the experimental group showed a
more positive view of general health and psychological health. Final
comparisons indicated an improvement in the experimental group in relation
to the placebo group in inhibitory control and improvement of the
experimental group along time in alternate attention. Both groups improved in
information processing, selective attention, executive functions and long term
visual memory. Placebo group showed improvements in relation to the
experimental group in measures of processing speed, concentration and long
term verbal memory. No differences were found in or quality of life. Both
groups improved along time in positive symptoms and general
psychopathology as measured by the Positive and negative Syndrome Scale
in Schizophrenia (PANSS). CONCLUSIONS: The low-cost cognitive training
which was proposed enabled some improvements in cognition, especially in
inhibitory control and presents itself as a valid treatment for people with
schizophrenia.
Descriptors: 1. cognition, 2. rehabilitation, 3. schizophrenia, 4.
neuropsychology, 5. mental health.