RESUMO
The durability of computer-assisted cognitive remediation (CACR) therapy over time and the cost-effectiveness of treatment remains unclear. The aim of the current study is to investigate the effectiveness of CACR and to examine the use and cost of acute psychiatric admissions before and after of CACR. Sixty-seven participants were initially recruited. For the follow-up study a total of 33 participants were enrolled, 20 to the CACR condition group and 13 to the active control condition group. All participants were assessed at baseline, post-therapy and 12 months post-therapy on neuropsychology, QoL and self-esteem measurements. The use and cost of acute psychiatric admissions were collected retrospectively at four assessment points: baseline, 12 months post-therapy, 24 months post-therapy, and 36 months post-therapy. The results indicated that treatment effectiveness persisted in the CACR group one year post-therapy on neuropsychological and well-being outcomes. The CACR group showed a clear decrease in the use of acute psychiatric admissions at 12, 24 and 36 months post-therapy, which lowered the global costs the acute psychiatric admissions at 12, 24 and 36 months post-therapy. The CACR is durable over at least a 12-month period, and CACR may be helping to reduce health care costs for schizophrenia patients.
Assuntos
Terapia Cognitivo-Comportamental/métodos , Remediação Cognitiva/métodos , Análise Custo-Benefício/métodos , Esquizofrenia/terapia , Terapia Assistida por Computador/métodos , Adulto , Terapia Cognitivo-Comportamental/economia , Remediação Cognitiva/economia , Feminino , Seguimentos , Hospitalização/economia , Humanos , Masculino , Testes Neuropsicológicos , Estudos Retrospectivos , Esquizofrenia/economia , Método Simples-Cego , Terapia Assistida por Computador/economia , Resultado do TratamentoRESUMO
BACKGROUND: Quality of life (QoL) is an important outcome in the treatment of schizophrenia. Cognitive deficits have an impact on functional outcomes. Cognitive remediation therapy is emerging as a psychological intervention that targets cognitive impairment, but the effect of computer-assisted cognitive remediation on neuropsychology and social functioning and wellbeing remains unclear. The aim of the current study is to investigate the neurocognitive outcomes of computer-assisted cognitive remediation (CACR) therapy in a sample of schizophrenia patients, and to measure the quality of life and self-esteem as secondary outcomes. METHODS: Sixty-seven people with schizophrenia were randomly assigned to computer-assisted cognitive remediation or an active control condition. The main outcomes were neuropsychological measures and secondary outcomes (self-esteem and quality of life). Measurements were recorded at baseline and post-treatment. RESULTS: The CACR therapy group improved in speed of processing, working memory and reasoning and problem-solving cognitive domains. QoL and self-esteem measures also showed significant improvements over time in this group. CONCLUSIONS: Computer-assisted cognitive remediation therapy for people with schizophrenia achieved improvements in neuropsychological performance and in QoL and self-esteem measurements.
Assuntos
Transtornos Cognitivos/reabilitação , Terapia Cognitivo-Comportamental/métodos , Qualidade de Vida/psicologia , Psicologia do Esquizofrênico , Autoimagem , Terapia Assistida por Computador , Adulto , Análise de Variância , Transtornos Cognitivos/etiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Testes Neuropsicológicos , Avaliação de Resultados em Cuidados de Saúde , Esquizofrenia/complicações , Adulto JovemRESUMO
OBJECTIVE: The aim of the study was to evaluate the intracytoplasmic sperm injection outcome in a selected group of patients with oligoasthenozoospermia in relation to the results obtained from their meiotic analysis. DESIGN: Retrospective clinical study. SETTING: An assisted reproduction service and a university department. PATIENT(S): One hundred thirty-seven men with oligoasthenozoospermia grouped in relation to their meiotic pattern. INTERVENTION(S): Two hundred twenty-four intracytoplasmic sperm injection cycles from 137 men with oligoasthenozoospermia in whom diagnostic meiotic analyses had been performed. MAIN OUTCOME MEASURE(S): Fertilization, pregnancy, implantation, and abortion rates. RESULT(S): There were no significant statistical differences in fertilization, pregnancy, implantation, or abortion rates among the three groups studied. CONCLUSION(S): No statistically significant differences in fertilization, pregnancy, implantation, or abortion rates were found in patients with oligoasthenozoospermia in relation to the meiotic pattern.