ABSTRACT

Objective

Cognitive remediation approaches for early course schizophrenia are promising interventions for improving social adjustment. Premorbid sociality is a potentially important moderator of social adjustment response to cognitive remediation and may serve to personalize such interventions.

Method

Eighty-eight early course schizophrenia outpatients with premorbid sociality scores were included in this preliminary investigation. Secondary data came from a recent 18-month multi-site confirmatory trial of Cognitive Enhancement Therapy (CET) compared to Enriched Supportive Therapy (EST). Intent-to-treat mixed effects models examined the moderating effect of premorbid sociality assessed at baseline on differential social adjustment change between CET and EST assessed at baseline, 9, and 18 months.

Results

Premorbid sociality significantly moderated the differential effect of CET vs. EST on overall social adjustment change at 18 months, such that CET was particularly effective for patients with high premorbid sociality and EST for low premorbid sociality. This significant group x time x premorbid sociality interaction was also observed for 18-month change in interpersonal anguish, self-care, and sexual relations. Again, CET was largely favorable for higher premorbid sociality patients and EST for lower premorbid sociality for these sub-scales.

Conclusions

The results provide initial evidence that premorbid sociality moderates differential social adjustment change during cognitive remediation in early course schizophrenia. In many, but not all cases, better social functioning prior to the development of schizophrenia was associated with a significantly better social adjustment response to CET. Data on social functioning during childhood and adolescence is possibly useful for personalizing treatment planning in the early course of schizophrenia.

中文翻译：

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在成人早期精神分裂症的认知增强治疗过程中，病前社会性缓和社会适应变化

摘要

客观的

早期精神分裂症的认知矫正方法是改善社会适应的有前途的干预措施。病前社会性是对认知矫正的社会适应反应的潜在重要调节剂，可能有助于使此类干预措施个性化。

方法

这项初步调查包括 88 名具有病前社会性评分的早期精神分裂症门诊患者。二级数据来自最近一项为期 18 个月的认知增强疗法 (CET) 与强化支持疗法 (EST) 相比的多中心验证性试验。意向治疗混合效应模型检查了基线评估的病前社会性对基线、9 个月和 18 个月评估的 CET 和 EST 之间差异社会适应变化的调节作用。

结果

病前社会性显着缓和了 CET 与 EST 对 18 个月时整体社会适应变化的不同影响，因此 CET 对病前社会性高的患者特别有效，而 EST 对病前社会性低的患者特别有效。这个显着的组 x 时间 x 病前社交互动也被观察到人际痛苦、自我照顾和性关系的 18 个月变化。同样，对于这些子量表，CET 在很大程度上有利于较高的病前社会性患者，而 EST 对较低的病前社会性患者。

结论

结果提供了初步证据，表明病前社会性在早期精神分裂症的认知矫正过程中缓和了不同的社会适应变化。在许多但不是所有情况下，在精神分裂症发展之前更好的社会功能与对 CET 的显着更好的社会适应反应相关。有关儿童和青春期社会功能的数据可能有助于精神分裂症早期的个性化治疗计划。