认知行为治疗对首发精神分裂症患者康复的影响

Effect of cognitive behavioral therapy on recovery of first episode schizophrenia

目的 探讨认知行为治疗对首发精神分裂症患者康复的影响.方法 将80例精神科住院的首发精神分裂症患者分为两组,对照组40例,采用常规药物治疗和护理,研究组40例,在患者住院2周后增加认知行为治疗.干预前后采用阳性和阴性症状量表（PANSS）、住院患者护士观察量表（NOSIE）、住院精神患者社会功能评定量表（SSPI）、症状评定量表（SCL-90）进行评定,并与对照组进行比较.结果 干预后两组患者NOSIE各因子分、总积极分、总消极分和SSPI量表、PANSS量表评分比较,经统计学分析,差异有统计学意义（P〈0.01）.研究组患者SCL-90量表因子中人际关系、抑郁、焦虑、敌对、恐怖、偏执、精神病性因子分明显减少（P〈0.05）.结论 认知行为治疗干预可明显加快首发精神分裂症患者的社会功能的恢复,提高患者生活质量,促进患者的康复.

Objective To evaluate the intervention effects of cognitive behavior therapy （CBT） on the patients with first episode schizophrenia. Methods A total of 80 patients with first episode schizophrenia were randomly divided into study group （n =40） and control group （n =40）. The study group was treated by routine drugs and psychiatric nursing after two weeks combining with CBT while the control group was treated only by routine drugs and psychiatric nursing. Both groups were assessed with Positive and Negative Syndrome Scale （PANSS）, Nurses Observation Scale for Inpatient Evaluation （NOSIE） , Scale of Social-skill for Psychiatric Inpatients （SSPI） , and Symptom Check List-90 （SCL-90） before and after CBT intervention. The scores of those scales were compared between two groups. Results There were significant differences after CBT intervention in all factors, total negative factors and total positive factors of NOSIE, total score of SSPI and PANSS （P〈0.01） between two groups. Factors score of interpersonal sensitivity, depression, anxiety, panic, paranoid ideation, and psychosis of SCL-90 in the study group decreased significantly after intervention. Conclusions It is suggested that CBT can improve social function and quality of life and facilitate recovery of the first-episode schizophrenia patients.