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논문 상세

주의력 재활 훈련이 정신분열병 환자의 인지 기능에 미치는 효과

The effect of computerized attention rehabilitation training on the improvement of cognitive functions in schizophrenic patients

초록

주의재활 훈련이 정신분열병 환자의 인지 기능의 향상과 증상 감소에 미치는 영향을 조사하였다. 주의재활은 전산화 인지재활 프로그램인 COMCOG로 이루어졌다. COMCOG의 주의재활 프로그램은 총 10 개의 세부 과제로 구성되어 있으며, 선택 주의, 지속 주의 및 주의 통합 등을 훈련하도록 개발되었다. 주의재활 훈련이 정신분열병 환자의 인지 기능에 미치는 영향은 언어/비언어 기억, 주의력, 실행 기능 등을 평가하는 신경심리검사를 사용하여 측정하였다. 주의훈련을 받은 정신분열병 환자군 (실험군)과 훈련을 받지 않은 환자군 (통제군)은 훈련 전에 실시한 신경심리검사에서는 유의한 차이가 없었다. 그러나 훈련 후에 실시한 신경심리검사에서는 유의한 차이가 관찰되었다. 즉 실험군이 통제군에 비하여 주의력을 평가하는 d2 검사와 Stroop 검사의 수행이 유의하게 향상되었으며, 실행 기능을 측정하는 위스콘신 카드분류 검사에서도 더 좋은 수행을 보였다. 또한 Rey 도형 검사의 즉각적 회상에서 더 좋은 정확성을 보였다. 이에 덧붙여서 주의재활 훈련을 받은 환자들에서는 훈련 전에 비하여 훈련 후에 음성 증상과 일반병리 증상이 유의하게 감소되었으나, 훈련을 받지 않은 환자들에서는 이러한 증상감소가 관찰되지 않았다. 이 결과는 인지재활 훈련이 만성정신분열병의 인지 기능의 향상에 효과적이며, 정신분열병의 치료에 인지 재활이 포함될 필요성이 있다는 것을 시사한다.

keywords
정신분열병, 전산화 인지재활 프로그램, 인지 기능, 신경심리검사, schizophrenia, computerized attention rehabilitation program, cognitive function, neuropsychological test, schizophrenia, computerized attention rehabilitation program, cognitive function, neuropsychological test

Abstract

This study have attempted to investigate the efficiency of the attention rehabilitation program on the improvement of the cognitive functions in the schizophrenic patients. The Computerized Cognitive Rehabilitation Treatment Program (COMCOG), which was developed for the rehabilitation of attention, was administered to 12 schizophrenic patients (treatment group). 12 schizophrenic patients were also served as controls (control group). The rehabilitation program was administered to the treatment group for 16 sessions, that is, 2 days a week for 2 months. For the evaluation of the cognitive functions, a number of neuropsychological tests were administered before and after the introduction of rehabilitation program. The results showed that the treatment group showed significant improvements on the d2 test, Stroop test, the immediate recall of RCFT, and the perseverated responses of WCST compared to the control group. These results indicate that the rehabilitation program is effective for the cognitive enhancement, in particular for the improvement of attention and executive function, for the chronic schizophrenic patients. In addition, the negative symptoms and general pathology of schizophrenia were significantly reduced after the rehabilitation treatment.

keywords
정신분열병, 전산화 인지재활 프로그램, 인지 기능, 신경심리검사, schizophrenia, computerized attention rehabilitation program, cognitive function, neuropsychological test, schizophrenia, computerized attention rehabilitation program, cognitive function, neuropsychological test

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