Download PDF
Psychiatr Prax 2001; 28(2): 60-68
DOI: 10.1055/s-2001-11577
ÜBERSICHT
Übersicht
© Georg Thieme Verlag Stuttgart · New York

Kognitive Funktionsstörungen bei schizophrenen Psychosen

Medikamentöse und psychologische BehandlungsverfahrenGabriele Sachs, Heinz Katschnig
  • Klinische Abteilung für Sozialpsychiatrie und Evaluationsforschung, Universitätsklinik für Psychiatrie, Wien
Further Information

Publication History

Publication Date:
31 December 2001 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Die Dichotomisierung schizophrener Symptomatik in „Plus-” und „Minussymptome”, die in letzter Zeit in erster Linie aus dem Blickwinkel der Psychopharmakologie erfolgte, hat die ja schon von Eugen Bleuler als zentral angesehenen kognitiven Störungen in den Hintergrund treten lassen. Dabei zeigen viele einschlägige Studien, dass schizophrene Patienten recht konsistent an kognitiven Störungen leiden. Dazu zählen in erster Linie Beeinträchtigungen der Daueraufmerksamkeit und der Gedächtnisfunktionen sowie der exekutiven Funktionen wie Planen und Problemlösen. Diese Störungen sind stabil oder progredient, bestehen oft auch während der Remissionsphasen der Schizophrenie weiter und beeinträchtigen sowohl die soziale Integration als auch die berufliche Leistungsfähigkeit. In der vorliegenden Übersichtsarbeit werden zunächst Forschungsergebnisse über kognitive Störungen bei Patienten mit schizophrenen Erkrankungen und ihre Beziehung zu psychosozialen Behinderungen beschrieben. Im Anschluss daran werden der therapeutische Wert und die möglichen Implikationen des Einsatzes der atypischen Antipsychotika und verschiedener kognitiver Therapiemethoden für die klinische Praxis dargestellt. Methodische Mängel und offene Fragen sowohl der pharmakologischen als auch der kognitiven Interventionen werden diskutiert.

Cognitive Dysfunctions in Schizophrenia - Medical and Psychological Treatment

Primarily from the perspective of psychopharmacology, schizophrenic symptomatology has recently been dichotomized into „plus” and „minus” symptoms, although the role of cognitive dysfunctions has been regarded as particularly important for the diagnosis since the time of Eugen Bleuler. Many studies show that schizophrenic patients suffer consistently from cognitive dysfunction. Among these, are impairments of attention and memory functions as well as executive functions such as planning and problem solving. These impairments are stable or progressive and often continue into the remission phase of schizophrenia and impair both social integration as well as occupational performance. In this overview, research results on cognitive dysfunction in patients with schizophrenic illnesses and their relation to psychosocial disabilities are described first. The therapeutic value and possible clinical-practice implications of atypical anti-psychotics and various cognitive therapy methods are then presented. Methodological weaknesses and open questions, both pharmacological and with regard to cognitive interventions, are discussed.

Literatur

  • 1 Kraepelin E. Dementia Praecox and Paraphrenia. Edinburgh; Livingstone 1919
    Search in Google Scholar
  • 2 Bleuler E. Lehrbuch der Psychiatrie. Berlin, Heidelberg; Springer Verlag 1983
    Search in Google Scholar
  • 3 Dilling H, Mourbom W, Schmidt M H. (Hrsg) .Internationale Klassifikation psychischer Störungen ICD-10. Bern, Göttingen, Toronto; Verlag Hans Huber 1991
    Search in Google Scholar
  • 4 Sass H, Wittchen H U, Zaudig M. (Hrsg) .Diagnostisches und Statistisches Manual Psychischer Störungen DSM-IV. Göttingen, Bern, Toronto, Seattle; Hogrefe 1996
    Search in Google Scholar
  • 5 Green M F. Schizophrenia from a neurocognitive perspective. Probing the impenetrable darkness. Boston; Allyn & Bacon 1998
    Search in Google Scholar
  • 6 Klosterkötter J. Kognition und Psychopathologie der Schizophrenie.  Fortschr Neurol Psychiatr. 1999;  62(2) S44-S52
    PubMedSearch in Google Scholar
  • 7 Zubin J, Spring B. Vulnerability - a new view of schizophrenia.  J Abnorm Psychol. 1977;  86 103-126
    CrossrefPubMedSearch in Google Scholar
  • 8 Brenner H D, Hodel B, Volker R, Corrigan R. Treatment of cognitive dysfunctions and behavioral deficits in schizophrenia.  Schizophr Bull. 1992;  18 21-26
    PubMedSearch in Google Scholar
  • 9 Penn D L, Mueser K T. Research update on the psychsocial treatment of schizophrenia.  Am J Psychiatry. 1996;  153 607-617
    PubMedSearch in Google Scholar
  • 10 Goldberg T E, Ragland J D, Torrey E F, Gold J M, Bigelow L B, Weinberger D R. Neuropsychological assessment of monozygotic twins discordant for schizophrenia.  Arch Gen Psychiatry. 1990;  47 1066-1072
    PubMedSearch in Google Scholar
  • 11 Palmer B W, Heaton R K, Paulsen J S. Is it possible to be schizophrenic yet neuropsychologically normal?.  Neuropsychology. 1997;  11 437-446
    CrossrefPubMedSearch in Google Scholar
  • 12 Nuechterlein K H, Dawson M E, Green M F. Information-processing abnormalities as neuropsychological vulnerability indicators for schizophrenia.  Acta Psychiatr Scand Suppl. 1994;  384 71-79
    PubMedSearch in Google Scholar
  • 13 Nuechterlein K H, Dawson M E. Information processing and attentional functioning in the developmental course of schizophrenic disorders.  Schizophr Bull. 1984;  10(2) 160-203
    PubMedSearch in Google Scholar
  • 14 Maruff P, Currie J. Neuropsychology of visual attentional deficits in schizophrenia. In: Pantelis C, Nelson HE, Barnes TRS A Neuropsychological Perspective. Chichester; Wiley & Sons Ltd 1996
    Search in Google Scholar
  • 15 Dawson M E, Haslett E A, Filion D L, Nuechterlein K H, Schell A M. Attention and schizophrenia: Impaired modulation of the startle reflex.  J Abnorm Psychol. 1993;  102 633-641
    CrossrefPubMedSearch in Google Scholar
  • 16 Aleman A, Ron Hijman M A, de Haan E HF, Kahn R S. Memory impairment in schizophenia: a meta-analysis.  Am J Psychiatry. 1999;  156, 9 1358-1366
    PubMedSearch in Google Scholar
  • 17 Brand A, Hildebrandt H, Scheerer E. Gedächtnisstörungen bei schizophrenen Erkrankungen.  Fortschr Neurol Psychiatr. 1996;  64 49-65
    PubMedSearch in Google Scholar
  • 18 Saykin A J, Gur R C, Gur R E. Neuropsychological function in schizophrenia: selective impairment in memory and learning.  Arch Gen Psychiatry. 1991;  48 618-624
    CrossrefPubMedSearch in Google Scholar
  • 19 Spitzer M, Braun U. Associative semantic network dysfunction in thought-disordered schizophrenic patients: Direct evidence from indirect semantic priming.  Biol Psychiatry. 1993;  34 864-877
    CrossrefPubMedSearch in Google Scholar
  • 20 Pantelis C, Barnes T RE, Nelson H E. Frontal-striatal cognitive deficits in patients with chronic schizophrenia.  Brain. 1997;  120 1823-1843
    CrossrefPubMedSearch in Google Scholar
  • 21 Hutton S B, Puri B K, Duncan L J. Executive function in first-episode schizophrenia.  Psychol Med. 1998;  28 463-473
    CrossrefPubMedSearch in Google Scholar
  • 22 Frith C D. The positive and negative symptoms of schizophrenia reflect impairments in the perception and initiation of action.  Psychol Med. 1987;  17 631-648
    PubMedSearch in Google Scholar
  • 23 Weinberger D R, Faith Berman K, Illowsky B P. Physiological dysfunction of dorsolateral prefrontal cortex in schizophrenia.  Arch Gen Psychiatry. 1988;  45 609-615
    PubMedSearch in Google Scholar
  • 24 Spindler K A, Sullivan E V, Menon V. Deficits in multiple systems of working memory in schizophrenia.  Schizophr Res. 1997;  27 1-10
    CrossrefPubMedSearch in Google Scholar
  • 25 Gold S, Arndt S, Nopoulos P, O'Leary D S, Andreasen N C. Longitudinal study of cognitive function in first-episode and recent schizophenia.  Am J Psychiatry. 1999;  156(9) 1342-1348
    PubMedSearch in Google Scholar
  • 26 Gallhofer B, Bauer U, Lis S, Krieger S, Gruppe H. Cognitive dysfunction in schizophrenia: comparison of treatment with atypical antipsychotic agents and conventional neuroleptic drugs.  Eur Neuropsychopharmacol. 1996;  6, Suppl 2 S13- S20
    PubMedSearch in Google Scholar
  • 27 Stolar N, Berenbaum H, Banich M T, Barch D. Neuropsychological correlates of alogia and affective flattening in schizophrenia.  Biol Psychiatry. 1994;  35 164-172
    CrossrefPubMedSearch in Google Scholar
  • 28 Hoffman R E, Stopec S, Andreasen C. A comparative study of manic vs. schizophrenic speech disorder.  Arch Gen Psychiatry. 1986;  43 831-838
    PubMedSearch in Google Scholar
  • 29 Green M F. What are the functional consequences of neurocognitive deficits in schizophrenia.  Am J Psychiatry. 1996;  153 321-330
    CrossrefPubMedSearch in Google Scholar
  • 30 Lysaker P H, Bell M D, Zito W S, Bioty S M. Social skills at work. Deficits and predictors of improvement in schizophrenia.  J Nerv Ment Dis. 1995;  183(11) 688-692
    PubMedSearch in Google Scholar
  • 31 Mueser K T, Bellak A S, Douglas M S, Wade J H. Prediction of social skill acquisition in schizophrenic and major affective disorder patients from memory and symptomatology.  Psychiatry Res. 1991;  37 281-296
    CrossrefPubMedSearch in Google Scholar
  • 32 Bellak A S, Sayers M, Mueser K, Bennett M. Evaluation of social problem solving in schizophrenia.  J Abnorm Psychol. 1994;  103 371-378
    CrossrefPubMedSearch in Google Scholar
  • 33 Bowen L, Wallace C J, Glynn S M, Nuechterlein K H, Lutzker J R, Kuehnel T G. Schizophrenic individuals' cognitive functioning and performance in interpersonal interactions and skills training procedures.  J Psychiatr Res. 1994;  28 289-301
    CrossrefPubMedSearch in Google Scholar
  • 34 Corrigan P W, Green M F, Toomey R. Cognitive correlates to social cue perception in schizophrenia.  Psychiatry Res. 1994a;  53 141-151
    CrossrefPubMedSearch in Google Scholar
  • 35 Corrigan P W, Wallace C J, Schade M L, Green M F. Cognitive dysfunctions and psychosocial skill learning in schizophrenia.  Behavior Therapy. 1994b;  25 5-15
    PubMedSearch in Google Scholar
  • 36 Buchanan R W, Holstein C, Breier A. The comparative efficacy and long-term effect of clozapin treatment on neuropsychological test performance.  Biol Psychiatry. 1994;  36 717-725
    CrossrefPubMedSearch in Google Scholar
  • 37 Goldman R S, Axelrod B N, Tandon R, Ribeiro S CM, Craig K, Berent S. Neuropsychological prediction of treatment efficacy and one-year outcome in schizophrenia.  Psychopathology. 193;  126 122-126
    PubMedSearch in Google Scholar
  • 38 Kern R S, Green M F, Satz R. Neuropsychological predictors of skills training for chronic psychiatric patients.  Psychiatry Res. 1992;  42 223- 230
    PubMedSearch in Google Scholar
  • 39 Bilder R M, Turkel E, Lipschutz-Broch L, Lieberman J A. Antipsychotic medication effects on neuropsychological functions.  Psychopharmacol Bull. 1992;  28 353-366
    PubMedSearch in Google Scholar
  • 40 Earle-Boyer E A, Serper M R, Davidson M, Harvey P D. Continous performance tests in schizophrenic patients: Stimulus and medication effects on performance.  Psychiatry Res. 1991;  37 37-46
    PubMedSearch in Google Scholar
  • 41 Keefe R, Silva S G, Perkins D O, Lieberman J A. The effects of atypical antipsychotic drugs on neurocognitive impairment in schizophrenia: a review and meta-analysis.  Schizophr Bull. 1999;  25(2) 201-222
    PubMedSearch in Google Scholar
  • 42 Meltzer H Y, Mc Gurk S R. The effects of clozapine, risperidone, and olanzapine on cognitive function in schizophrenia.  Schizophr Bull. 1999;  25(2) 233-255
    CrossrefPubMedSearch in Google Scholar
  • 43 Hagger C, Buckley P, Kenny J T, Freidman L, Ubogy D, Meltzer H Y. Improvement in cognitive function and psychiatric symptoms in treatment-refractory schizophrenic patients receiving clozapine.  Biol Psychiatry. 1993;  34 702-712
    CrossrefPubMedSearch in Google Scholar
  • 44 Buchanan R W, Holstein C, Breier A. The comparative efficacy and long-term effect of clozapine treatment on neuropsychological test performance.  Biol Psychiatry. 1994;  36 717-725
    CrossrefPubMedSearch in Google Scholar
  • 45 Lee M A, Thompson P, Meltzer H Y. Effects of clozapine on cognitive function in schizophrenia.  J Clin Psychiatry. 1994;  55, Suppl B 8-14
    PubMedSearch in Google Scholar
  • 46 Hoff A L, Faustman W O, Wieneke M, Espinoza S, Costa M, Wolkowitz O, Csernansky J C. The effects of clozapine on symptom reduction, neurocognitive function, and clinical management in treatment refractory state hospital schizophrenic inpatients.  Neuropsychopharmacology. 1996;  15 361-369
    CrossrefPubMedSearch in Google Scholar
  • 47 Gallety C A, Clark C R, Mc Farlane A C, Weber D L. Relationship between changes in symptoms ratings, neuropsychological test performance, and quality of life in schizophrenic patients with clozapine.  Psychiatry Res. 1997;  72 161-166
    CrossrefPubMedSearch in Google Scholar
  • 48 Zahn T P, Pickar D, Haier R J. Effects of clozapine, fluphenazine, and placebo on reaction time measures of attention and sensory dominance in schizophrenia.  Schizophr Res. 1994;  13(2) 133-144
    CrossrefPubMedSearch in Google Scholar
  • 49 Fujii D E, Ahmed I, Jokumsen M, Compton J M. The effects of clozapine on cognitive functioning in treatment resistant schizophrenic patients.  J Neuropsychiatry Clin Neurosci. 1997;  9 240-245
    PubMedSearch in Google Scholar
  • 50 Mayer-Lindenberg A, Gruppe H, Bauer U, Lis S, Krieger S, Gallhofer B. Improvement of cognitive function in schizophrenic patients receiving clozapine or zotepine: Results from a double-blind study.  Pharmacopsychiatry. 1997;  30(2) 35-42
    PubMedSearch in Google Scholar
  • 51 Daniel D G, Goldberg T E, Weinberger D R, Kleinman J E, Pickar D, Lubick L J, Williams T S. Different side effect profiles of risperidone and clozapine in 20 outpatients with schizophrenia or schizoaffective disorder: A pilot study.  Am J Psychiatry. 1966;  153 417-419
    PubMedSearch in Google Scholar
  • 52 Rossi A, Mancini F, Stratta P. Risperidone, negative symptoms and cognitive deficits in schizophrenia: an open study.  Acta Psychiatr Scand. 1997;  95 40-43
    PubMedSearch in Google Scholar
  • 53 Mc Gurk SR,Green M F, Wirshing W C, Ames D, Marshall B D, Marder S M. The effects of risperidone vs. haloperidol on cognitive function in treatment-resistant schizophrenia. The Trail Making Test.  CNS Spectrums. 1997;  2 60-64
    PubMedSearch in Google Scholar
  • 54 Gallhofer B, Bauer U, Lis S, Krieger S, Gruppe H. Cognitive dysfunction in schizophrenia: comparison of treatment with atypical antipsychotic agents and conventional neuroleptic drugs.  Eur Neuropsychopharmacol. 1996;  6(2) S13-S20
    PubMedSearch in Google Scholar
  • 55 Stip E. Memory Impairment in Schizophrenia: Perspectives from Psychopathology and Pharmacotherapy.  Can J Psychiatry. 1996;  41(2) 27-34
    PubMedSearch in Google Scholar
  • 56 Green M .F, Marshall B D, Wirshing M D, Ames D, Marder S R, McGurk S, Kern R S, Mintz J. Does risperidone improve verbal working memory in treatment-resistant schizophrenia?.  Am J Psychiatry. 1997;  154 799-804
    PubMedSearch in Google Scholar
  • 57 Purdon S E, Jones B, Chouinard G, Stip E, Tollefson G. Neuropsychological change in early phase schizophrenia over twelve months of treatment with olanzapine, risperidone or haloperidol.  Schizophr Res. 1998;  29(1,2) 152-153
    PubMedSearch in Google Scholar
  • 58 Harvey P D. Cognitive effects of risperidone versus olanzapine in patients with schizophrenia or schizoaffective disorder. Abstract. Annual Meeting of the American Psychiatric Association; May 13 - 18. Chicago; 2000
    Search in Google Scholar
  • 59 Fleming K. Effects of quetiapine on cognition.  Schizophr Res. 1997;  24 197
    PubMedSearch in Google Scholar
  • 60 Velligan D I, Miller A L. Cognitive dysfunction in schizophrenia and its importance to outcome: the place of atypical antipsychotics in treatment.  J Clin Psychiatry. 1999;  60 25-28
    PubMedSearch in Google Scholar
  • 61 Libermann R P, De Lisi W J, Mueser K T. Social skills training for psychiatric patients. New York; Pergamon Press 1989
    Search in Google Scholar
  • 62 Brenner H D, Stranke W G, Mewes W G, Liese J, Seeger G. Erfahrungen mit einem spezifischen Therapieprogramm zum Training kognitiver und kommunikativer Fähigkeiten in der Rehabilitation chronisch schizophrener Patienten.  Nervenarzt. 1980;  51 106-112
    PubMedSearch in Google Scholar
  • 63 Roder V, Brenner H D, Kienzle N, Hodel B. Integriertes Psychologisches Therapieprogramm für schizophrene Patienten (IPT). Dritte überarbeitete und ergänzte Auflage. München, Weinheim; Beltz 1995a
    Search in Google Scholar
  • 64 Brenner H D, Hodel B, Kube G, Roder V. Kognitive Therapie bei Schizophrenen: Problemanalyse und empirische Ergebnisse.  Nervenarzt. 1987;  58 72-83
    Search in Google Scholar
  • 65 Hermanutz M, Gestrich J. Kognitives Training mit Schizophrenen.  Nervenarzt. 1987;  58 91-96
    PubMedSearch in Google Scholar
  • 66 Kraemer S, Sulz K HD, Schmid R, Lässle R. Kognitive Therapie bei standardversorgten schizophrenen Patienten.  Nervenarzt. 1987;  58 (2) 84-90
    PubMedSearch in Google Scholar
  • 67 Heim M, Wolf S, Göthe U, Kretschmar J. Kognitives Training bei schizophrenen Erkrankungen.  Psychiatrie, Neurologie und medizinische Psychologie. 1989;  41 367-375
    PubMedSearch in Google Scholar
  • 68 Olbrich R, Mussgay L. Reduction of schizophrenic deficits by cognitive training. An evaluative study.  Eur Arch Psychiatry Clin Neurolsci. 1990;  239 366-369
    PubMedSearch in Google Scholar
  • 69 Funke B, Reinecker H, Commichau A. Grenzen kognitiver Trainingsmethoden bei schizophrenen Langzeitpatienten.  Nervenarzt. 1989;  60 750-756
    PubMedSearch in Google Scholar
  • 70 Bender W L, Gertz K, John F, Mohr F, Vaitl P, Wagner U. Kognitive Trainingsprogramme bei Patienten mit schizophrener Residualsymptomatik. Untersuchungen über Wirksamkeit und klinische Erfahrungen.  Neuropsychiatrie. 1987;  2 212-217
    PubMedSearch in Google Scholar
  • 71 Brenner H D, Hodel B, Roder V, Corrigan P. Treatment of cognitive dysfunctions and behavioral deficits in schizophrenia.  Schizophr Bull. 1992;  18 21-26
    PubMedSearch in Google Scholar
  • 72 Hodel B, Brenner H D. Cognitive therapy with schizophrenic patients: conceptual basis, present state, future directions.  Acta Psychiatr Scand. 1994;  90, Suppl 384 108-115
    PubMedSearch in Google Scholar
  • 73 Hermanutz M, Gestrich J. Computer-assisted attention training in schizophrenics: A comparative study.  European Arch of Psychiatry and Neurological Science. 1991;  240(4 - 5) 282-287
    PubMedSearch in Google Scholar
  • 74 Marker K. Cogpack Ladenburg (marker software). 
  • 75 Geibel-Jakobs M, Olbrich R. Computergestütztes kognitives Training bei schizophrenen Patienten.  Psychiatr Prax. 1998;  25 111-116
    PubMedSearch in Google Scholar
  • 76 Olbrich R. Psychological methods of cognitive deficit reduction. Experiences with a computer training program.  Fortschr Neurol Psychiatr. 1999;  2 S74-S76
    PubMedSearch in Google Scholar
  • 77 Spaulding W D, Fleming S K, Reed D, Sullivan M, Storzbach D, Lam M. Cognitive Functioning in Schizophenia: Implications for Psychiatric Rehabilitation.  Schizophr Bull. 1999;  25 275-289
    CrossrefPubMedSearch in Google Scholar
  • 78 Green M F. Cognitive Remediation in schizophrenia: Is it time yet?.  Am J Psychiatry. 1993;  150 178-187
    PubMedSearch in Google Scholar
  • 79 Asarnow R F, Mac Crimmon D J. Span of apprehension deficits during the postpsychotic stages of schizophrenia: A replication and extension.  Arch Gen Psychiatry. 1981;  38 1006-1011
    PubMedSearch in Google Scholar
  • 80 Wohlberg G W, Kornetsky C. Sustained attention in remitted schizophrenics.  Arch Gen Psychiatry. 1973;  28 533-537
    PubMedSearch in Google Scholar
  • 81 Heaton R K. Wisconsin Card Sorting Test Manual. Psychological Assessment Resources. Florida; Odessa 1981
    Search in Google Scholar
  • 82 Benedict R HB, Harris A E, Makkow T, McCormick J A, Nuechterlein K H, Asarnow R F. The effects of attention training in information processing in schizophrenia.  Schizophr Bull. 1994;  20 537-46
    PubMedSearch in Google Scholar
  • 83 Kern R S, Wallace C J, Hellman S G, Womack L M, Green M F. A training procedure for remediating WCST deficits in chronic psychotic patients: An adaptation of errorless learning principles.  J Psychiatr Res. 1996;  30 283-294
    CrossrefPubMedSearch in Google Scholar
  • 84 Medalia A, Aluma M, Tryon W, Merriam A E. Effectiveness of attention training in schizophrenia.  Schizophr Bull. 1998;  24 147-152
    PubMedSearch in Google Scholar
  • 85 Goldberg T E, Weinberger D R, Berman K F, Pliskin N H, Podd M H. Further evidence of dementia of the prefrontal type in schizophrenia? A controlled study of teaching the Wisconsin Card Sorting Test.  Arch Gen Psychiatry. 1987;  44 1008-1014
    CrossrefPubMedSearch in Google Scholar
  • 86 Bellak A S, Mueser K T, Morrison R L, Tierney A, Podell K. Remediation of cognitive deficits in schizophrenia.  Am J Psychiatry. 1990;  147 1650-1655
    PubMedSearch in Google Scholar
  • 87 Green M F, Satz P, Ganzell S, Vaclav J F. Wisconsin Card Sorting Test Performance in schizophrenia: Remediation of a Stubborn Deficit.  Am J Psychiatry. 1992;  149(1) 62-68
    PubMedSearch in Google Scholar
  • 88 Goldman R S, Axelrod B N, Tandon R. Analysis of executive functioning in schizophrenics using the Wisconsin Card Sorting Test.  J Nerv Ment Dis. 1991;  179 506-507
    PubMedSearch in Google Scholar
  • 89 Stratta P, Mancini F, Mattei P, Daneluzzo E, Bustini M, Casacchi M, Rossi A. Remediation of Wisconsin Card Sorting Test performance in Schizophrenia.  Psychpathology. 1997;  30 59-66
    PubMedSearch in Google Scholar
  • 90 Rosell S, David A. Improving performance on the WCST: variations on the orginal procedure.  Schizophr Res. 1997;  28 63-76
    CrossrefPubMedSearch in Google Scholar
  • 91 Vollema M G, Geurtsen G J, Van Voorst A JP. Durable improvements in Wisconsin Card Sorting Test performance in schizophrenic patients.  Schizophr Res. 1995;  16 209-15
    CrossrefPubMedSearch in Google Scholar
  • 92 Delahunty A, Morice R, Frost B. Specific cognitive flexibility, rehabilitation in schizophrenia.  Psychol Med. 1993;  23 221-227
    PubMedSearch in Google Scholar
  • 93 Young D A, Freyslinger M A. Scaffolding instruction and the remediation of the Wisconsin Card Sort Test deficits in chronic schizophrenia.  Schizophr Res. 1995;  16 199-207
    CrossrefPubMedSearch in Google Scholar
  • 94 Metz J T, Johnson M D, Pliskin N H. Maintenance of training effects on the Wisconsin Card Sorting Test by patients with schizophrenia and affective disorders.  Am J Psychiatry. 1994;  151 120-122
    PubMedSearch in Google Scholar
  • 95 Kern R S, Green M F, Goldstein M J. Modification of performance on the Span of Apprehension, a putative marker of vulnerability to schizophrenia.  J Abnorm Psychol. 1995;  104 385-409
    CrossrefPubMedSearch in Google Scholar
  • 96 O'Carroll R E, Rusell H H, Lawrie S M, Johnstone E C. Errorless learning and the cognitive rehabilitation of memory-impaired schizophrenic patients.  Psychol Med. 1999;  29 105-112
    CrossrefPubMedSearch in Google Scholar
  • 97 Wykes T, Reeder C, Corner J, Williams C, Everitt B. The effects of neurocognitive remediation on executive processing in patients with schizophrenia.  Schizophr Bull. 1999;  25 291-307
    PubMedSearch in Google Scholar
  • 98 Stip E, Lussier I, Ngan E, Mendrek A, Kiddle P. Discriminant cognitive factors in responder and non-responder patients with schizophrenia.  Eur Psychiatry. 1999;  14 442-450
    CrossrefPubMedSearch in Google Scholar
  • 99 Wiedl K H, Wienöbst J, Schöttke H, Kauffeldt S. Differentielle Aspekte kognitiver Remediation bei schizophren Erkrankten auf der Grundlage des Wisconsin Card Sorting Tests.  Zeitschr Klin Psychol. 1999;  28 214-219
    PubMedSearch in Google Scholar
  • 100 Bellak A S, Blachard J J, Murphy P, Podell K. Generalization effects of training on Wisconsin Card Sorting Test for schizophrenia patients.  Schizophr Res. 1996;  19 189-194
    CrossrefPubMedSearch in Google Scholar
  • 101 Olbrich R. Psychologische Verfahren zur Reduktion kognitiver Defizite. Erfahrungen mit einem computergestützten Trainingsprogramm.  Fortschr Neurol Psychiatr. 1999;  62(2) S74-S76
    PubMedSearch in Google Scholar
  • 102 Bowen L, Wallace C J, Glynn S M, Nuechterlein K H, Lutzker J R, Kuehnel T G. Schizophrenic individuals' cognitive functioning and performance in interpersonal interactions and skills training procedures.  J Psychiatr Res. 1994;  28 289-301
    CrossrefPubMedSearch in Google Scholar
  • 103 Spring B J, Ravdin L. Cognitive remediation in schizophenia: should we attempt it?.  Schizophr Bull. 1992;  18 15-20
    PubMedSearch in Google Scholar
  • 104 Hogarty G E, Flesher S. Cognitive remediation in schizophrenia: proceed … with caution!.  Schizophr Bull. 1992;  18 51-57
    PubMedSearch in Google Scholar
  • 105 Liberman R P, Green M F. Whither cognitive-behavioral therapy for schizophrenia?.  Schizophr Bull. 1992;  18 27-35
    PubMedSearch in Google Scholar
  • 106 Suslow T, Arolt V. Effektivität eines computergestützten Aufmerksamkeitstrainings bei schizophrenen Patienten.  Psychiatr Prax. 1998;  25 105-110
    PubMedSearch in Google Scholar
  • 107 Vauth R, Dietl M, Stieglitz R D, Olbrich H M. Kognitive Remediation. Eine neue Chance in der Rehabilitaton schizophrener Störungen?.  Nervenarzt. 2000;  71 19-29
    CrossrefPubMedSearch in Google Scholar
  • 108 Smith T E, Hull J W, Romanelli S, Fertuck E, Weiss K A. Symptoms and neurocogniton as rate limiters in skills training for psychotic patients.  Am J Psychiatry. 1999;  156 1817-1818
    Search in Google Scholar
  • 109 Green M F, Nuechterlein K H. Should schizophrenia be treated as a neurocognitive disorder?.  Schizophr Bull. 1999;  25 309-319
    CrossrefPubMedSearch in Google Scholar
  • 110 Danion J M, Weingartner H, Singer L. Is cognitive psychopathology plausible? Illustration from memory research.  Can J Psychiatry. 1996;  41 5S-13S
    PubMedSearch in Google Scholar

Dr. med. Dr. phil. Gabriele Sachs

Universitätsklinik für Psychiatrie

Klinische Abt. für Sozialpsychiatrie u. Evaluationsforschung

Währinger Gürtel 18 - 201090 WienÖsterreich

Email: sachga1@akh-wien.ac.at