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PubMedDate not supplied

Differential methods of enhancing cognitive growth in urban preschool children.

The investigation was carried out to design and test more purposeful and structured methods of promoting intellectual growth in culturally deprived preschool children. The relative merits of providing specific cognitive training both in a nursery setting and in the home through the influence of the mother were assessed. Four groups each of 15 children were involved in the experiment, which extended over a period of four months. Gains were confirmed for both general intelligence and linguistic competence. Both the two nursery groups and the experimental "home" group all showed considerable improvement, the latter being comparable to the nursery control group.

Child Development↗
PubMed2006

Clinical practice with anti-dementia drugs: a consensus statement from British Association for Psychopharmacology.

The British Association for Psychopharmacology (BAP) coordinated a meeting of experts to review the evidence on the drug treatment for dementia. The level of evidence (types) was rated using a standard system: Types 1a and 1b (evidence from meta-analysis of randomised controlled trials or at least one controlled trial respectively); types 2a and 2b (one well-designed study or one other type of quasi experimental study respectively); type 3 (non-experimental descriptive studies); and type 4 (expert opinion). There is type 1a evidence for cholinesterase inhibitors (donepezil, rivastigmine and galantamine) for mild to moderate Alzheimer's disease; memantine for moderate to severe Alzheimer's disease; and for the use of bright light therapy and aromatherapy. There is type 1a evidence of no effect of anti inflammatory drugs or statins. There is conflicting evidence regarding oestrogens, with type 2a evidence of a protective effect of oestrogens but 1b evidence of a harmful effect. Type 1a evidence for any effect of B12 and folate will be forthcoming when current trials report. There is type 1b evidence for gingko biloba in producing a modest benefit of cognitive function; cholinesterase inhibitors for the treatment of people with Lewy body disease (particularly neuropsychiatric symptoms); cholinesterase inhibitors and memantine in treatment cognitive impairment associated with vascular dementia; and the effect of metal collating agents (although these should not be prescribed until more data on safety and efficacy are available). There is type 1b evidence to show that neither cholinesterase inhibitors nor vitamin E reduce the risk of developing Alzheimer's disease in people with mild cognitive impairment; and there is no evidence that there is any intervention that can prevent the onset of dementia. There is type 1b evidence for the beneficial effects of adding memantine to cholinesterase inhibitors, and type 2b evidence of positive switching outcomes from one cholinesterase inhibitor to another. There is type 2a evidence for a positive effect of reminiscence therapy, and type 2a evidence that cognitive training does not work. There is type 3 evidence to support the use of psychological interventions in dementia. There is type 2 evidence that a clinical diagnosis of dementia can be made accurately and that brain imaging increases that accuracy. Although the consensus statement dealt largely with medication, the role of dementia care in secondary services (geriatric medicine and old age psychiatry) and primary care, along with health economics, was discussed. There is ample evidence that there are effective treatments for people with dementia, and Alzheimer's disease in particular. Patients, their carers, and clinicians deserve to be optimistic in a field which often attracts therapeutic nihilism.

Aged↗
PubMedDate not supplied

Ergoloids and ischaemic strokes; efficacy and mechanism of action.

In this double-blind, randomized study the efficacy of the ergoloid compounds, co-dergocrine mesylate and nicergoline, in the rehabilitation of patients with ischaemic stroke was investigated. A group of 30 patients was treated daily with 60 mg nicergoline, orally, and a second group of 27 patients was given 1.8-6 mg co-dergocrine mesylate, orally or intramuscularly, daily (depending on the time since the initial ischaemic insult) for 6 months. Outcome measures included: motoricity index (limb function); Sandoz Clinical Assessment Geriatric (SCAG) scale; psychometric tests to assess functions such as attention, psychomotor performance, perception and sensory and short-term memory; conventional and computerized electroencephalography; and P300 and reaction time measures. The results showed improvements in some aspects such as limb function (P < 0.05), SCAG score (P < 0.01) and some electrophysiological parameters (P < 0.01) after treatment with both drugs. Though statistically significant most of the changes were not large. The efficacy of both drugs was qualitatively similar. The quantitative difference in some aspects in favour of nicergoline could be attributed to differences in the mechanisms of action of the two drugs, although it is also possible that the difference may reflect the dosages used. Nootropic drugs may induce a condition that facilitates the effects of cognitive training.

Adult↗
PubMed2002

[Psychiatric rehabilitation in a French-speaking setting: current practices, future challenges].

This paper aims to assess current interventions in psychiatric rehabilitation in the French-speaking world and to discuss future developments. We review examples of policies and practices in Quebec and Europe and discuss the role and involvement of professionals; namely, the psychiatrists and the nursing staff. We also present different rehabilitation strategies and techniques used in the French-speaking world, such as case management, social-skills training, cognitive therapies for psychotic symptoms, family interventions, and return-to-work interventions. In conclusion, we invite psychiatrists to play a more active role in rehabilitation. We recommend the creation of small, specialized units closely linked to the needs of clients, and we propose to integrate social and medical interventions, rather than opposing them.

Case Management↗
PubMed2002

A dynamic test to assess learning capacity in people with severe impairments.

Because traditional intelligence tests do not allow a reliable and valid estimate of the general cognitive abilities of individuals with IQs lower than 55, a dynamic test of analogical reasoning (Analogical Reasoning Learning Test-ARLT) was constructed for use with this population. The aim of the test is to distinguish individuals who could undergo more ambitious schooling and cognitive training from those who would profit little or none from such an intervention. Internal consistency and test-retest reliability of this measure are high. Discriminant and predictive validity, assessed with another learning test and with a one-month training on inductive reasoning, respectively, are satisfactory. The test is seen as a useful tool for diagnostic differentiation among low performers.

Adolescent↗
PubMed2026

AI-Driven Precision Medicine in Alzheimer's Disease: Drug Repurposing, Digital Therapeutics and Clinical Decision Support.

Alzheimer's Disease (AD) is a neurodegenerative disease that causes significant clinical, social, and economic burden worldwide. Despite improvements in understanding its multifaceted pathogenesis, current treatments are mostly symptomatic and ineffective across varied patient populations. To overcome these constraints, AI-driven precision medicine allows tailored risk assessment, treatment selection, and disease monitoring. This review covers AI's role in AD precision medicine, focusing on drug repurposing, digital therapies and clinical decision support systems. Machine and deep learning models are used to predict medication response, integrate heterogeneous data sources such as genomics, transcriptomics, neuroimaging and electronic health records, and uncover pharmacogenomic treatment success factors. The paper covers AIenabled precision pharmacology, including tailored dosing algorithms, adaptive therapeutic monitoring, and adverse drug reaction prediction. Bioinformatics-based target identification, network pharmacology, graphbased AI models, virtual screening, and real-world and clinical data validation are emphasized in AI-driven medication repurposing. AI-powered digital treatments like personalized cognitive training platforms, wearable- derived digital biomarkers, virtual and mixed reality interventions, adherence monitoring, and digital twins for therapy optimization have been discussed. AI-based clinical decision support systems are also thoroughly assessed for clinical value, accuracy, and explainability in disease subtyping, trajectory prediction, and risk stratification in preclinical and prodromal AD. Despite these promises, data heterogeneity, algorithmic bias, legal barriers, and privacy concerns exist. Federated learning enables safe multi-center collaboration and hybrid AI-human approaches, and it represents the future. AI's ability to alter AD care opens the door to precision medicine paradigms that use repurposed medications, digital tools and intelligent decision-making to improve patient outcomes.

Alzheimer&#x2019;s disease↗
PubMed1998

Short-term effects of coping skills training as adjunct to intensive therapy in adolescents.

OBJECTIVE: Given the urgent need to develop effective programs that improve the ability for adolescents to achieve metabolic control equivalent to programs studied in the Diabetes. Control and Complications Trial, we have undertaken a clinical trial to determine if a behavioral intervention (coping skills training [CST]) combined with intensive diabetes management can improve metabolic control and quality of life in adolescents implementing intensive therapy regimens. RESEARCH DESIGN AND METHODS: A total of 65 youths between the ages of 13 and 20 years, who elected to initiate intensive insulin therapy, were randomly assigned to one of two groups: the intensive management with CST group and the intensive management without CST group. CST consists of a series of small group efforts designed to teach adolescents the coping skills of social problem-solving, social skills training, cognitive behavior modification, and conflict resolution. Data were collected at pre-intervention and at 3 months following the use of the Self-Efficacy for Diabetes scale, Children's Depression Inventory, Issues in Coping with IDDM scale, and the Diabetes Quality of Life: Youth scale. Clinical data (HbA1c, adverse effects) were collected monthly. RESULTS: The experimental and control groups were comparable on all measures at baseline. Results show that adolescents who received CST had lower HbA1c and better diabetes self-efficacy and were less upset about coping with diabetes than adolescents receiving intensive management alone. In addition, adolescents who received the CST found it easier to cope with diabetes and experienced less of a negative impact of diabetes on quality of life than those who did not receive CST. CONCLUSIONS: CST is useful in improving not only an adolescent's metabolic control, but also their quality of life. As more pediatric providers aim for improved control, in adolescents with diabetes, the addition of this behavioral intervention may be helpful in achieving metabolic and life goals.

Adaptation, Psychological↗
PubMedDate not supplied

Disability in dementia: assessment, prevention, and rehabilitation.

Dementia involves cognitive impairment sufficient to interfere with daily living. Most cases of dementia are due to Alzheimer's disease or cerebrovascular disease. Surveys show that dementia is one of the major causes of disability in the elderly, affecting personal care, everyday cognitive activities, and social behaviour. Several instruments relying on informant reports or behavioural observation have been developed to assess these various components of disability in dementia. Prevention of dementia would make a major contribution to the postponement of disability in old age. In principle, this could be achieved by modifying risk factors for Alzheimer's disease or vascular dementia. There is presently scope for the prevention of vascular dementia, but risk factors for Alzheimer's disease are not sufficiently understood. The paper discusses how, where dementia has already developed, programmes involving cognitive training or environmental redesign can help to maintain skills and reduce behavioural disturbances.

Aged↗
PubMed1998

Psychogenic vomiting: report of two cases.

Two patients were admitted to our hospital with the diagnosis of psychogenic vomiting of more than 9 months' duration. Both were treated with a combination of pharmacotherapy, relaxation training, cognitive therapy and supportive psychotherapy. Behavioral therapy and verbal catharsis were also used in one of the cases involving bereavement. The intervention was not directly aimed at the vomiting, but at the aspects of the patients' stress and emotional problems. Change in condition was assessed on basis of the frequency of vomiting and the severity of anxiety and depression. Vomiting was found to be positively related to anxiety but not to depression. These 2 patients improved to the extent that the disturbance caused by vomiting was significantly reduced, and the reduction was closely related to the severity of anxiety. Both were also found to have similar personality traits and family types, which have been reported to be related to psychogenic vomiting. We review the characteristics of psychogenic vomiting and relate some important considerations for treating Chinese psychogenic vomiting cases.

Adult↗
PubMed1992

[A pilot study: neuropsychological rehabilitation of patients with solvent-induced toxic encephalopathy].

Fourteen patients with chronic toxic encephalopathy underwent a neuropsychological intervention comprising crisis therapy, information about the disease, and cognitive training. Evaluation showed the patients to have experienced substantial improvement in their daily life and family relations as a result of the intervention. Their affective symptoms decreased and their verbal memory improved. Regional cerebral blood flow (rCBF) measurements showed training-dependent changes of functional activity related to change in memory strategy. This rCBF change had disappeared six months later, however, suggesting that the duration of intervention needs to be extended in order for use of the learned memory techniques to become automatic. We conclude that neuropsychological rehabilitation is effective and should be made available to patients with chronic toxic encephalopathy.

Adult↗
PubMedDate not supplied

Clinical efficacy of methylphenidate in children and adolescents.

The efficacy of methylphenidate (MTP) is amply documented for children with ADHD. In addition to modifying the central features of the disorder, inattention, impulsive behavior and excessive motor activity, the medication has been shown also to improve social behavior with peers and adults, as well as academic performance. The concerns that these benefits may not extend beyond the period of active intervention, and that treatment efficacy in only partial in some children, has led to the development of other, psychosocial interventions. Behavioral treatment by itself is ineffective, but contributes significantly to clinical change in children who derive incomplete gains from MTP alone. Cognitive training has not been shown to have therapeutic impact either as a single treatment, or as an adjunct to MTP. Clinical indications for MTP extend to children and adolescents with Conduct disorders. Treatment affects antisocial behavior regardless of the concurrent presence of hyperactivity symptomatology. Extended treatment with MTP alone is difficult to implement in older children due to lack of cooperation. MTP has been shown to be safe. Deceleration of growth velocity is the only identified long-term side effect. It occurs after more than one year of treatment at greater than low doses. It appears completely reversible with treatment cessation prior to the adolescent growth spurt. Efficacy in Attention Deficit-Hyperactivity Disorder (ADHD) is especially well demonstrated in preadolescents, with only sparse evidence for efficacy in adolescents.

Adolescent↗
PubMed1995

Dementia treatment: a German perspective on psychosocial aspects and therapeutic approaches.

Because of the growing number of elderly people, the incidence of dementia is increasing. The disease represents a heavy burden for patients and their relatives and has growing social and financial implications. Unfortunately, research and therapeutic progress is slowed by methodological differences in the assessment of dementia and a therapeutic nihilism toward antidementia drugs. However, the limited efficacy of some antidementia drugs should not obscure the fact that a definite placebo-verum difference has been proved for other drugs and that the combination of these drugs with other therapeutic methods, like cognitive training, does bring positive results. Their use also seems meaningful in terms of economics.

Activities of Daily Living↗
PubMed1998

Contributions of respiratory care practitioners to intensive care: a review.

Through the years, the professional practice of respiratory care has continually evolved to include management of critically ill patients. Although the functions and duties of respiratory care practitioners (RCPs) in this setting may vary across different institutions, it is widely recognised throughout the United States that RCPs contribute importantly to intensive care unit (ICU) outcomes. The American Association for Respiratory Care (AARC) has painstakingly established guidelines to more precisely define the role of RCPs in performing procedures in the ICU. Published studies demonstrate the added value of RCPs' collaboration in several ICU activities, including placement of arterial catheters, sampling of arterial blood gases, endotracheal intubation, and management of and weaning from mechanical ventilation. Other ICU activities in which RCPs participate include assisting with bronchoscopy, obtaining haemodynamic measurement, and indirect calorimetry and supporting specialised techniques such as extracorporeal membrane oxygenation (ECMO) and continuous veno-venous haemofiltration and/or haemodiafiltration (CVVH/CVVHD). Based on the demonstrated impact of RCPs and their technical and cognitive training, a continuing role expansion for RCPs in the ICU is expected.

Airway Obstruction↗
PubMed1976

EMG-biofeedback reduction of tension headache: a cognitive skills-training approach.

The biofeedback literature affirms the therapeutic efficacy of EMG-biofeedback-assisted relaxation for the treatment of tension headache. However, this form of therapy has failed to focus on the role of cognitive variables in the control and perception of tension headache. The present case study provides a prototype treatment combining cognitive behavior--modification procedures with EMG-biofeedback training to treat a subject with chronic tension headache. Phase I, baseline, involved collecting mean EMG and daily headache activity, emphasizing specification of environmental stressors. Phase II, cognitive skills--training, focused on: (1) identifying negative self-statements (cognitions) related to stressors, and (2) training the subject to replace negative self-statements with coping self-instructions. This treatment resulted in a 33% headache reduction over baseline, with no concomitant changes in frontalis EMG. Phase III, EMG-biofeedback training, resulted in a 38% reduction in mean EMG level and a 66% reduction in mean headache activity when compared to baseline. The results suggest the importance of attending to cognitive factors in the treatment of tension headache.

Adult↗
PubMed2001

Manual-guided cognitive-behavioral therapy training: a promising method for disseminating empirically supported substance abuse treatments to the practice community.

A gap exists between empirically supported substance abuse treatments and those used in community settings. This study examined the feasibility of training substance abuse counselors to deliver cognitive-behavioral treatment (CBT) using treatment manuals. Participants were 29 counselors. Counselors were randomly assigned to receive CBT training or to a control group. Counselor attitudes were assessed pre- and posttraining. In addition, CBT therapy sessions were videotaped and rated for adherence and skillfulness. CBT counselors reported high levels of satisfaction with the training, intention to use CBT interventions, and confidence in their ability to do so. Ratings indicated that 90% of counselors were judged as having attained at least adequate levels of CBT skillfulness. Findings demonstrate the feasibility of using psychotherapy technology tools as a means of disseminating science-based treatments to the substance abuse practice community.

Adult↗
PubMed1999

Chronic low-back pain: what does cognitive coping skills training add to operant behavioral treatment? Results of a randomized clinical trial.

This study examined the supplemental value of a cognitive coping skills training when added to an operant-behavioral treatment for chronic low-back pain patients. The complete treatment package (OPCO) was compared with an operant program + group discussion (OPDI) and a waiting-list control (WLC). After the WL period, the WLC patients received a less protocolized operant program usually provided in Dutch rehabilitation centers (OPUS). Regression analyses showed that, compared with WLC, both OPCO and OPDI led to less negative affect, higher activity tolerance, less pain behavior, and higher pain coping and pain control. At posttreatment, OPCO led to better pain coping and pain control than OPDI. Calculation of improvement rates revealed that OPCO and OPDI had significantly more improved patients than OPUS on all the dependent variables. The discussion includes findings regarding treatment credibility, compliance, and contamination bias.

Adaptation, Psychological↗
PubMed2005

Short-term effects of cognitive behavioural group training (CBGT) in adult Type 1 diabetes patients in prolonged poor glycaemic control. A randomized controlled trial.

AIMS: To assess the effects of cognitive behavioural group training (CBGT) on glycaemic control, diabetes self-efficacy and well-being in Type 1 diabetes patients in persistent poor glycaemic control. METHODS: In a randomized controlled trial, a total of 107 patients with Type 1 diabetes in poor glycaemic control (HbA(1c) > or = 8%) were assigned to a 6-week CBGT or blood glucose awareness training (BGAT) as control condition. The intervention was preceded by a 3-month run-in period. Glycaemic control (HbA(1c)), diabetes-specific self-efficacy (CIDS), diabetes-related distress (PAID) and depressive symptoms (CES-D), were assessed at baseline (T1), directly before (T2) and 3 months after (T3) the intervention. RESULTS: No significant changes in HbA(1c) were found after CBGT, whilst diabetes self-efficacy increased (mean CIDS score 71.6 +/- 14.0 to 74.3 +/- 12.2) and diabetes-related distress (mean PAID score 47.0 +/- 21.6 to 42.6 +/- 20.8) and depressive symptoms decreased (mean CES-D score 16.9 +/- 12.8 to 13.5 +/- 12.6). Changes in psychological outcomes were similar for both treatment groups. Diabetes self-care behaviours improved equally. Drop-out rate, which was higher among CBGT participants, was relatively low overall (total n = 15, 17.05%), and both interventions were well-appreciated by the participants. CONCLUSIONS: CBGT was successful in improving self-efficacy, diabetes-related distress and mood at 3 months' follow-up, but not in improving glycaemic control.

Adult↗