精神分裂症患者恢复期应用行为治疗的作用分析

Effects of behavior treatment for schizophrenia patients during recovery stage

目的:观察认知行为治疗对恢复期精神分裂症患者病耻感及伴发轻、中度焦虑、抑郁的影响。方法:运用单盲随机对照方法,选取符合入组条件的100例恢复期精神分裂症病人,随机分配到认知行为治疗组(CBT组,n=50)和支持性心理治疗组(ST组,n=50)。在药物治疗的基础上,CBT组接受8次认知行为治疗,ST组接受8次支持性心理治疗。两组病人分别于入组时、治疗4周末和12周末评定精神疾病患者病耻感量表中文版(SSMI-C),汉密顿抑郁量表(HAMD)和焦虑自评量表(SAS),比较两组的得分差异。结果:在治疗4周末及12周末,SSMI-C在总分,歧视因子,病情掩饰因子和积极效应因子得分上,CBT组明显低于ST组,差异具有统计学意义(P<0.01);在治疗4周末和12周末,CBT组的HAMD总分明显低于ST组,差异具有统计学意义(P<0.01);在治疗12周末,CBT组在SAS总分低于ST组,差异具有统计学意义(P<0.01)。结论:认知行为治疗能改善恢复期精神分裂症患者的病耻感及伴发的轻、中度焦虑和抑郁。

Objective： To evaluate the efficacy of cognitive behavioral therapy on stigma fellow anxiety and depression with rehabilitation schizophrenia. Methods： Single blind methods was applied to choose 100 patients with rehabilitation schizo- phrenia, then randomly assigned them into cognitive behavioral therapy group （CBT group,n= 50）, and support phychotherapy group（ST group,n=50）,The patients accepted 8 sessions of CBT or ST respectively based on the same drug therapy. Stigma Scale for rnental（SSMI-C）, Hamilton Depression scale（HAMD）, and Self-rating anxiety Scale（SAS） were used to assess the efficacy and difference of scores at baseline,weeks 4 and 12 blindly. Results： In CBT group,the total score and three factors of SSMI-C were lower at weeks 4 and 12 than that in ST group（P〈0.01）, the total score of HAMD were lower at weeks 4 and 12 than that in ST group（P〈0.0l）, the total score of SAS were lower at weeks 12 than that in ST group（P〈0.01）. All differences were significant. Conclusion： It suggests that cognitive behavioral therapy could improve the stigma fellow anxiety and depression of the patients with rehabilitation schizophrenia.