[Evidence based treatment of executive dysfunction].

Abstract

The therapy of executive functions plays an essential role for the functional outcome and the social reintegration. Nevertheless there is a lack of cognitive oriented and evidence-based therapy programs. The purpose of our review is the classification of the present evaluation studies with regard of the principles of evidence based medicine (EbM) and of the content. Besides the EbM criteria the number of participants, the kind and number of interventions, the types of etiology and the standardisation and quality of the outcome parameters are measured. By that, an assessment should be possible, which interventions are successful for what types of dysexecutive syndrome. The present studies belong to three different types of therapy: at first, a therapy form focussing on manipulation and modification of the environment, second, a therapy form using behaviour management and a third form, which is based on practise and cognitive interventions. The heterogeneity of the therapy forms makes different types of evaluation necessary. The evaluation studies reach different classes of evidence. While the cognitive therapy forms reach comparable high evidence classes, the evaluation studies about behaviour management--mostly present as single case studies with individual outcome parameter--reach only low evidence classes. Final, we discuss, which therapy forms are effective using the strong evaluation criteria and at which point further conceptual task and further research is useful.