职业治疗对住院精神分裂症患者认知功能的随机对照研究

Effect of occupational treatment on recognitive function of hospitalized schizophrenias

目的评价职业治疗对精神分裂症恢复期患者认知功能的改善作用。方法将200例符合美国精神疾病诊断标准第4版(DSM-Ⅳ)中精神分裂症诊断标准的患者随机分为职业治疗组(研究组)和工娱治疗组(对照组),每组100例。所有患者在入院时及治疗8周后使用阴性、阳性症状量表(PANSS)、社会功能缺陷筛查量表(SDSS)、威斯康星卡片分类测验(WCST)等测量工具进行评定。两组患者在2周后抗精神病药物加到治疗量的基础上分别使用职业治疗和一般工娱治疗进行干预。结果两组治疗前PANSS、WCST、SDSS评分差异无统计学意义(P>0.05);研究组治疗2个月后PANSS减分率大于对照组(P<0.01),正确反应数显著大于对照组(P<0.01),持续错误数显著小于对照组(P<0.05),治疗出院后两周SDSS评分显著低于对照组(P<0.01)。结论在精神分裂症者康复治疗中,职业治疗对精神分裂症患者精神症状、认知功能的改善,明显优于一般工娱治疗,能够明显改善精神分裂症患者恢复期的社会功能,提高生活质量。

Objective To evaluate the effect of occupational therapy on the recovery of cognitive function in patients withschizophrenia. Methods Totally 200 cases meeting the diagnostic criteria of schizophrenia by American psychiatric diagnosisstandard in the 4th edition（DSM- Ⅳ） were selected and randomly divided into occupational therapy group（study group） andthe work entertainment treatment group（control group）. 100 cases in each group. On the basis of antipsychotic drug treatment,the cases in two groups were treated with occupational therapy and general work＆entertainment treatment, respectively. The in-dexes of patients at admission and two weeks after treatment were measured and assessed with negative and positive symptomsscale（PANSS）, social function defect screening scale（SDSS）, Wisconsin card sorting test（WCST）, and other measurementtools. Results No significant differences in scores of PANSS,WCST, and SDSS between two groups before treatment werefound.Two weeks after treatment the reduction rate of PANSS points was significantly greater than that of the control group（P〈0.01）. The correct response number tested by WCST was significantly greater than that of the control group（P〈 0.01）, and thenumber of continuous errors was significantly lower than the control group（P〈0.05）. Two weeks after discharge, the SDSSscores of the patients in study group were significantly lower than that of the control group（P〈 0.01）. Conclusion In the reha-bilitation treatment of schizophrenia, the effects occupational treatment of schizophrenia patients with psychiatric symptomsand the improvement of cognitive function were superior to the general work ＆entertainment treatment, it can also significantlyimprove the schizophrenia patients’ social function in the recovery and their life quality.