The effect of errorless learning on psychotic and affective symptoms, as well as aggression and apathy in patients with Korsakoff's syndrome in long-term care facilities

Int Psychogeriatr. 2019 Jan;31(1):39-47. doi: 10.1017/S1041610218000492. Epub 2018 Jun 20.

Abstract

ABSTRACTObjectives:Errorless learning is a promising rehabilitation principle for learning tasks in patients with amnesia, including patients with Korsakoff's syndrome. Errorless learning might possibly also contribute to decreases in behavioral and psychiatric problems, as patients in long-term care facilities become more independent after training. The aim of this study was to examine the effects of errorless learning on potential changes in psychotic and affective symptoms, aggression and apathy, in contrast with a control group who received care as usual.

Methods: The current study is a quasi-experimental study on errorless learning and psychotic and affective symptoms, aggression, and apathy in patients with Korsakoff's syndrome, living in long-term care facilities for patients with Korsakoff's syndrome (KS) in the Netherlands. The GIP-28, HoNOS-ABI, and NVCL-20 were administered to a group of patients with KS who received errorless learning training (n = 51) and a patient control group who received care as usual (n = 31). Wilcoxon Signed-Rank Tests were performed to examine psychotic and affective symptoms, aggression, and apathy at baseline and at follow-up in the errorless learning group and the control group.

Results: Errorless learning training effectively reduced psychotic symptoms (including provoked confabulations), affective symptoms, and agitation/aggression. There were no significant changes (increases nor decreases) in the control group. Levels of apathy were stable over time in both groups.

Conclusions: Results with respect to psychotic and affective symptoms, aggression, and apathy are discussed in depth. Patients with KS can become more autonomous in a cared for setting using errorless learning principles. This might also result in decreases in behavioral and psychiatric problems in patients.

Keywords: Korsakoff's syndrome; affect; aggression; apathy; depression; errorless learning; psychotic.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Affective Symptoms / psychology*
  • Aged
  • Aggression / psychology*
  • Apathy*
  • Female
  • Humans
  • Korsakoff Syndrome / psychology
  • Korsakoff Syndrome / rehabilitation*
  • Learning*
  • Long-Term Care
  • Male
  • Middle Aged
  • Netherlands
  • Psychiatric Status Rating Scales