社交技能训练改善精神分裂症患者阴性症状

Effects of social skill training on the negative symptoms of schizophrenia

目的探讨社交技能训练对精神分裂症患者阴性症状、情绪表达的影响。方法将140例恢复期精神分裂症患者随机分为干预组(74例)和对照组(66例)。对干预组进行小组式社交技能训练,于训练前及训练后12个月采用阴性症状量表(SANS)、Montgomery-Asberg抑郁量表(MADRS)评定。结果在训练后12个月时干预组的SANS总分(35.5)低于对照组(39.0)(Z=-2.684,P<0.05),对照组12个月时N4评分大于入组时评分(Z=-3.652,P<0.05);在MADRS评分中,除内心紧张、自杀观念外,干预组的其余评分和总分低于对照组(Z总分=-4.125,Z2=-2.389,Z7=-2.290,Z8=-2.992,Z9=-2.350,P<0.05),对照组的入组时和12个月相比,总分差异无统计学意义(P>0.05)。结论在药物治疗的基础上,系统而规则的社交技能训练可改善精神分裂症患者的阴性症状,延缓或阻止其社交退缩的发生,促进患者的情绪表达。

Objective： To explore the effect of social skill training for negative symptoms and emotional expression in patients with schizophrenia. Methods： One hundred and forty patients with schizophrenia after episode were divided into intervention and control groups randomly. Systemic group social skill training was conducted for intervention group for 12 months. Scale for the assessment of negative symptoms（SANS） and the Montgomery Asberg depression rating scale （MADRS） were used for evaluation at the base line and ending point of 12 months training. Results： After 12 months training, the total score of SANS in intervention group （ 35.5 ） were significantly lower（ Z = - 2.684, P 〈 0.05 ） than that in control group （ 39.0 ）, and the score of N4 in SANS were hyper （ Z = - 3. 652, P 〈 0.05 ） at the ending point compared with the base line in control group. Except inner tension and suicide ideas, both the total scores of MADRS and the other item scores in intervention group were significantly lower than that in control group （Z all = -4. 125 ,Z2 = -2. 389 ,Z7 = - 2.290,Z8 = -2.992 ,Z9 = -21 350, all P 〈 0.05 ）. Meanwhile, there was no significant difference between the baseline scores and the scores after 12 months of MADRS in control group （P 〉 0.05）. Conclusion： Systemic social skill training can reduce the negative symptoms and improve the emotional expression for schizophrenic patients.