社会技能训练对慢性精神分裂症疗效的对照研究

Effectiveness of Social Skills Training in Patients with Chronic Schizophrenia

目的 :探讨社会技能训练对慢性精神分裂症阳性症状、阴性症状及认知功能的疗效。方法 :将 10 0例慢性精神分裂症患者随机分为训练组 (5 0例 )和对照组 (5 0例 )。对训练组按照LibermanRP编写的《社会独立生活技能》训练程式进行训练 ,共 12周。用BPRS、SANS、SDSI和WCST进行评定。结果 :(1)训练组BPRS在总分和焦虑抑郁及缺乏活力因子分低于对照组 ,差异有显著性 (P <0 0 5 )。 (2 )接受 12周社交技能训练后 ,训练组的SANS量表全部五个因子和总分低于对照组 ,均有显著差异 (P <0 0 5 )。 (3 )训练组和对照组在WCST的 5个指标 ,差异有显著性 (P <0 0 5 )。 (4 )SDSI评定结果表明 ,训练后明显降低 ,差异有显著性 (P <0 0 5 )。结论 :社会技能训练能够改善慢性精神分裂症的阳性症状。

Objective:To study the efficacy of social skill-training on the positive symptoms, negative symptoms and cognitive function of patients with chronic schizophrenia.Method:100 subjects who met with the criteria of Chinese Classification and Diagnostic Criteria of Schizophrenia were randomly assigned to the skill-training group (50 patients) and the control group (50 patients). Under the condition of stable antipsychotic medication, the skill-training group received the skill-training course offered by Liberman RP for 12 weeks. BPRS and SANS were used to evaluate every four weeks; WCST and SDSI were evaluated before and after the treatment.Result:(1) 45 patients of skill-training group and 46 patients of control group completed the study. (2) There were significant differences between skill-training group and control group in total score, anxiety depression and lacking active factor of BPRS (P<0.05). The decreasing rate of the five factors' BPRS score showed significant difference between skill-training and control group starting from 8 or 12 weeks. (3) After receiving 12 weeks skill-training course, all five factors (flat affect, poverty of thought, lack of will, poor mood and disturbance of attention) of SANS and the total score in skill-training group were significant lower compared to control group(P<0.05). The decreasing rate of the flat affect, poverty of thought, lack of will and SANS total score showed significant difference between skill-training and control group starting 8 weeks (P<0.05). (4) There were significance in CC, PR, PE, TE and TCL between skill-training group and control group (P<0.05). (5) The results of SDSI evaluation before and after skill-training showed that there was significant difference before and after skill-training in skill -training group, and between skill-training and control group.Conclusion:The positive symptoms, negative symptoms and cognitive function of chronic schizophrenics could be improved by the social skill-training.