Magazine article Clinical Psychiatry News

Address Cognitive Deficits in Schizophrenia. (One Intervention Is Errorless Learning)

Magazine article Clinical Psychiatry News

Address Cognitive Deficits in Schizophrenia. (One Intervention Is Errorless Learning)

Article excerpt

PITTSBURGH--The functional outcomes of schizophrenia are determined much more by the way in which cognitive deficits are addressed than by treatment of psychotic symptoms, Dr. Michael F. Green said at a conference on schizophrenia sponsored by the University of Pittsburgh.

"There was a notion that by controlling the symptoms, that would act like a rising tide that would bring all of the 'boats' up higher with it," said Dr. Green of the University of California, Los Angeles, Neuropsychiatric Institute. "It doesn't work that way, and we can't expect it to work that way"

Adequate interventions for cognitive deficits arguably lag far behind interventions for psychotic symptoms. Interventions that incorporate methods that compensate for such deficits work best in improving the functional outcomes of schizophrenic patients until restorative approaches are available, he said at the meeting.

An example of a compensatory intervention for schizophrenic patients with cognitive deficits is errorless learning. Dr. Green was an investigator in a study of 65 medicated outpatients with schizophrenia or schizoaffective disorder who randomly received errorless learning or conventional instruction for entry-level clerical or assembly positions (Am. J. Psychiatry 159[11]:1921-26, 2002). "This was more like a vocational rehab simulation--not exactly what is done in the community," he said.

Conventional training teaches patients how to do a complete task without breaking the task into smaller steps. …

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