ABSTRACT

After acquired brain injury (ABI) many patients suffer from persistent cognitive and emotional disturbances. The aim of this study was to investigate the treatment outcome of an integrated intervention, combining neuropsychological and cognitive behavioural therapy (nCBT), against waitlist (WL) in outpatients with ABI. Individuals seeking outpatient treatment for cognitive and emotional problems after ABI were randomly allocated to nCBT (n = 27) or WL (n = 29) and completed assessments at baseline, post-treatment/WL and at six-month follow-up. The primary outcome measures were general psychopathology and functional activity in daily life. The nCBT group showed significant improvement for general psychopathology post-treatment when compared to WL. nCBT was also superior to WL regarding the secondary outcomes, i.e., the reduction of negative affect and the improvement of quality of life. No significant differences for functional activity and community integration were observed. Significant pre–post effect sizes ranged between small for functional activity and medium for quality of life. The positive effects were maintained at follow-up. The majority of patients with cognitive and emotional problems after ABI benefit from an integrated approach that offers cognitive remediation and psychotherapy. However, the heterogeneous sequelae of ABI and the moderate sample sizes in clinical trials present a methodological challenge to ABI research.

摘要

在获得性脑损伤 (ABI) 后，许多患者遭受持续的认知和情绪障碍。本研究的目的是调查结合神经心理学和认知行为疗法 (nCBT) 的综合干预对 ABI 门诊患者候补名单 (WL) 的治疗结果。在 ABI 后因认知和情绪问题寻求门诊治疗的个体被随机分配到 nCBT ( n  = 27) 或 WL ( n = 29) 并在基线、治疗后/WL 和六个月的随访中完成评估。主要结果测量是日常生活中的一般精神病理学和功能活动。与 WL 相比，nCBT 组在一般精神病理学治疗后表现出显着改善。nCBT 在次要结果方面也优于 WL，即减少负面影响和提高生活质量。没有观察到功能活动和社区整合的显着差异。显着的前后效应大小介于功能活动的小和生活质量的中等之间。积极影响在随访中得以维持。大多数在 ABI 后出现认知和情绪问题的患者都受益于提供认知补救和心理治疗的综合方法。