认知行为治疗改善自杀未遂精神分裂症患者生命质量的对照研究

Comparative study about cognitive behavioral therapy improved life quality of suicide patients with schizophrenia

目的观察认知行为治疗对自杀未遂精神分裂症患者的心理健康状况及生命质量改善的效果,为制定提高精神分裂症患者自杀预防水平、降低和防止精神分裂症患者再次自杀的策略提供临床依据。方法选取符合《国际疾病分类(第10版)》(ICD-10)中精神分裂症诊断标准的、自杀未遂的住院患者共130例,按住院号末尾数字随机分配到认知行为治疗组(治疗组,n=66)和对照组(n=64)。治疗组给予12周的常规药物治疗,以及每次约50分钟共8次的短程认知行为治疗。对照组只给予常规药物治疗12周。分别于治疗前、治疗12周末采用WHO生存质量简表(WHOQOL-BREF)评估患者的健康状况,生命质量量表(QOLS)评定患者的生命质量,抑郁自评量表(SDS)评定患者的抑郁情绪,社会支持评定量表(SSRS)评定患者的社会支持状况。结果与治疗前相比,治疗12周末SDS、WHOQOL-BREF、QOLS总分差异有统计学意义(P<0.01);较治疗前治疗组SSRS总分差异有统计学意义(P<0.05),对照组差异无统计学意义(P>0.05)。两组相比,SDS、WHOQOL-BREF、QOLS总分差异有统计学意义(P<0.01),SSRS总分差异无统计学意义(P>0.05)。结论认知行为治疗可能有助于改善自杀未遂精神分裂症患者的生命质量和心理健康状况。

Objective To observe the effect of cognitive - behavioral therapy on mental health of suicide patients with schiz- ophrenia and quality of life improvement, to provide clinical guidance for suicide patients with schizophrenia in preventing, reduc- ing and avoiding repeated suicide behaviors. Methods According to the international classification of diseases, Tenth Edition of mental and behavioral disorders （ ICD - 10） in the diagnosis of suicide patients with schizophrenia inpatients were 130 cases. They were randomly allocated into treatment group according to the admission number digit which was Cognitive - behavioral therapy group （ treatment group,n = 66） and control group （ n = 64）. Short term cognitive - behavioral therapy in treatment group were treated with routine drug treatment which continued for 12 weeks and eight timescognitive behavioral therapy which lasted 50 mi- nutes every time, while the control group only received routine drug treatmentfor 12 weeks. Respectively, before treatment, after 12 weeks, using WHO health scale （WHOQOL -BREF） to assess the patient~ health status, quality of life scale （QOLS） to evaluate the quality of life of patients, and self rating Depression Scale （SDS） to rate patients depression, also social support rating scale （SSRS） to assess social support of patients. Results Compared with before treatment, after 12 weeks treatment selected patients shown statistically significant difference in SDS, WHOQOL - BREF, QOLS score （P 〈 O. 01 ） ;and the treatment group had statistically significant differences in SSRS scores from the beginning （P 〈 0.05） whilethe control group had no significant difference （P 〉 0.05）. When compared two groups , they shown statistical signif- icance difference in SDS, WHOQOL -BREF, QOLS score （P 〈 0.01 ） but no significant differences in SSRS score. Conclusion Cognitive - behavioral therapy may help to improve quality of life and mental health status of the suicide patients with schizo- phrenia.