自閉スペクトラム症に対する前頭葉／実行機能プログラム（FEP）を用いた認知機能改善療法の効果研究

Cognitive Remediation Therapy (CRT) using Frontal/Executive Program (FEP) for autism spectrum disorder

要旨：認知機能改善療法の1つである前頭葉／実行機能プログラム（FEP）を，自閉スペクトラム症（以下，ASD）をもつ複数の人を対象に日本で初めて行った研究である．ASDでは社会認知のみならず神経認知機能障害も存在し，近年では統合失調症の障害領域との類似も報告されている．今回は4例を対象に認知機能，社会生活能力，自己効力感に着目し，FEPがそれらに及ぼす効果について検討した．その結果，ほとんどの症例に認知機能，自己効力感，社会生活能力および社会的転帰の改善が認められた．FEPが認知機能の改善に有効なだけでなく，その治療システムがASDをもつ人への自信や達成感，自己効力感の獲得とつながり，社会的転帰への契機になったと考えられる．

　Objective: To study the effects of the Frontal/Executive Program (FEP), a type of Cognitive Remediation Therapy (CRT), on cognitive function, social function, and self-efficacy in people with autism spectrum disorder (ASD). Method: The intervention consisted of 44 sessions of FEP over a period of approximately six months. Cognitive function, social function, and self-efficacy were evaluated before and after the intervention. Results: Improvements were shown based on scales in both the Brief Assessment of Cognition in Schizophrenia-Japanese version composite and in overall informant and interviewer evaluations in the Schizophrenia Cognition Rating Scale-Japanese version, the total Life Assessment Scale for the Mentally Ill, and Generalized Self-Efficacy Scale. These results suggest that FEP improves outcomes in tests of cognitive function, social function, and self-efficacy. Conclusion: FEP may be a useful CRT tool for improving cognitive function, social function, and self-efficacy outcomes in patients with ASD. Future studies are needed to determine the duration of effects of FEP.