Browsing by Subject "toipuminen"

Objectives: Research has shown that cognitive deficits are a significant part of schizophrenia. Patients with schizophrenia show poorer performance in multiple areas of cognition such as memory functions, processing speed and executive functions. This review focuses to examine the range of specific executive function deficits in first-episode schizophrenia and how these deficits change during 1-3 year follow up period. Furthermore, the review focuses on viewing whether executive functioning is related to clinical profile, clinical outcome or functional outcome. Methods: The research was executed as a literature review. Search of literature was focused to executive functioning in adult first-episode schizophrenia. The following keywords were used in google scholar and Helka finna databases: ”first episode schizophrenia”, ”schizophrenia” combined with keywords ”executive functions”, ”cognitive functions” and ”cognitive deficits”. Keyword “outcome” was combined with the previous when searching for outcome articles. Some of the articles used were found from other research articles and they were included in the review if they met the same inclusion criteria. Results and conclusions: First-episode schizophrenics showed broad executive function deficits in multiple specific areas of function. Problems were systematically seen in working memory, cognitive flexibility, fluency, inhibition and planning. In addition, there were conflicting results about attention allocation and initiation. Executive deficits did not seem to change drastically during a 1-3 year follow up period, but cognitive flexibility skills were assessed to improve in multiple studies. Moreover, research shows that negative and disorganization symptoms relate to executive dysfunction. Several studies considering relation between executive function and outcome show that there is a link between executive functioning and functional outcome. Studies considering clinical outcome were conflicted and certain conclusions cannot yet be drawn. However, it seems that planning abilities might be related to clinical outcome but there is a need for further study.

Apraxia and aphasia occur frequently together. Producing speech and using other means of communication such as gesturing is challenging for persons with a severe apraxia-aphasia. Prior research concerning the recovery of persons with a severe apraxic-aphasic disorder is limited. The aim of this study was to examine the possible changes in gesturing among persons with severe apraxic-aphasic disorder between one and three years after stroke. The goal was to investigate the changes in recognizability of the gestures produced after a verbal command. Additionally, the possible effects on recognizability of the gestures by showing a picture of an object related to the gestures or a gesture model were investigated. The sample used in this study was part of the Long-term recovery from apraxia-aphasia after a left hemisphere stroke research project and included seven persons with a severe apraxic-aphasic disorder. The gesturing was assessed using The Florida Apraxia Screening Test-Revised (FAST-R) on two study occasions – after one year and after three years of stroke. The results were analyzed both qualitatively and quantitatively. The findings of this study suggest that changes in gesturing among persons with severe apraxic-aphasic disorder are possible between one and three years after stroke. However, there was much variation in the performance between the participants. The performance on gesturing after a verbal command improved in four persons and remained approximately the same in three persons. At group level the changes in gesturing after a verbal command were not statistically significant. Generally, showing a gesture model improved the recognizability of the gestures substantially more compared to showing a picture. Persons with severe apraxic-aphasic disorder can benefit from showing a picture or gesture model in gesture production, but there was considerable variation between the participants.