认知行为治疗慢性精神分裂症对照研究

A controlled study of cognitive behaviour therapy in chronic schizophrenia

目的探讨抗精神病药物联合认知行为疗法治疗慢性精神分裂症患者阳性症状的临床疗效。方法将100例有持续幻觉和/或妄想等阳性症状的慢性精神分裂症患者随机分为研究组48例,对照组52例。两组均维持原抗精神病药物治疗,研究组联合认知行为治疗,对照组联合普通心理治疗。观察3mo。于治疗前及治疗3mo末采用简明精神病量表评定临床疗效。结果治疗3mo末,研究组有效率91.7%,对照组为76.9%,研究组显著高于对照组(χ2=4.04,P<0.05);简明精神病量表评分,治疗3mo末研究组总分、幻觉和思维障碍因子分均较治疗前有显著性下降(P<0.01),对照组总分有显著性下降(P<0.01),但研究组总分、幻觉和思维障碍因子分均较对照组下降显著。结论认知行为治疗有助于改善慢性精神分裂症患者的阳性症状。

Objective To explore the clinical efficacy of antipsychotics plus cognitive behaviour therapy （CBT） in positive symptoms of chronic schizophrenics. Methods 100 patients with positive symptoms such as persistent hallucination and/or delusion were randomly assigned to research （n = 48） and control group （n=52）. Both groups maintained antipsychotic treatment, the research group was plus CST and the control plus common psychotherapy for 3 months. Before treatment and at the end of 3 month treatment clinical efficacies were assed with the Brief Psychiatric Rating Scale（BPRS）. Results At the end of 3 months, effective rates were 91.7% in the research and 76.9% in the control respectively, which showed significant difference （P〈0.05）; according to the BPRS, total, hallucination and thinking disturbance score lowered more significantly after treatment than pretreatment in the research （P〈0.01） and than in the control group ,so did the total score in the control（P〈0.01）. Conclusion Cognitive behaviour therapy makes for improving positive symptoms of chronic schizophrenia.