团体认知行为治疗对服用利培酮的精神分裂症患者的认知功能影响对照研究

A Comparative Study of the Effects of Cognitive Behavioral Therapy on Cognitive Function in Schizophrenia

目的:探讨认知行为治疗对精神分裂症认知功能恢复及精神症状的改善在治疗中所产生的作用。方法:来自我院住院符合ICD-10精神分裂症诊断标准的的患者60例,随机分为药物联合团体认知行为治疗(研究组)30例,药物治疗组(对照组)30例,两组均采用利培酮单一药物治疗,研究组每周进行1次团体认知行为治疗,于基线期,2、4、8、12周末,使用阳性与阴性症状量表(PANSS)对精神症状评定,采用蒙特利尔认知评价量表(MoCA)进行认知功能评定。结果:在治疗第二周时研究组PANSS阳性症状项目减分高于对照组(t=2.24;P=0.02),第4、8周末阴性因子分研究组减分高于对照组(t=2.61,P=0.01;t=3.67,P=0.001),12周末研究组在阴性因子分(t=3.54,P=0.001)、总分(t=2.07,P=0.04)比较上减分高于对照组。通过MoCA量表对认知功能评定,研究组在第二周时执行功能分值高于对照组(t=2.29,P=0.02),第4周较执行功能(t=2.14,P=0.03)、抽象(t=2.30,P=0.02)和总分(t=3.09,P=0.003)研究组高于对照组。第8周执行功能及总分研究组高于对照组的同时出现注意(t=2.63,P=0.01),延迟回忆(t=2.58,P=0.01)高于对照组,第12周末时两组间比较执行功能(t=2.05,P=0.04),注意(t=2.38,P=0.02),延迟回忆(t=2.57,P=0.01),总分(t=3.11,P=0.003)研究组均高于对照组。结论:对精神分裂症患者在药物治疗同时联合团体认知行为治疗在精神症状的改善和认知功能的恢复上均取得较好的疗效。

Objective：To explore the effect of cognitive behavior therapy on the recovery of cognitive function and the improvement of psychiatric symptoms in schizophrenia.Methods：A total of 60 patients in our hospital who met ICD-10 criteria for schizophrenia were included;The patients were randomly divided into two groups：Drug group cognitive behavior therapy（study group）and Drug treatment group（control group）,30 cases in each group.The two groups were treated with risperidone monotherapy.The study group received a weekly group cognitive behavioral therapy.At baseline,2,4,8,12 weekends,we evaluated psychiatric symptoms using PANSS scale;The Montreal cog-nitive assessment scale（MoCA）was used to assess cognitive function.Results：In the second week of treatment,the reduced score of PANSS positive symptom in study group was higher than that of the control group（t =2.24,P 〈0.05）.The reduced scores of negative factor in study group at the 4th and 8th week were higher than those of the control group（t =2.67,3.67 P 〈0.01）.In the 12 weekend,the reduced negative score and the reduced total scores in study group were higher than those of the control group（t =3.54,2.07 P 〈0.05）.The cognition functional scores as-sessed by the MoCA scale was higher in the second week in the study group than that in the control gruop（t =2.29, P 〈0.05）.At the fourth week,the executive,abstract function and total scores were higher in study group than those in the control group（t =2.14,2.30,3.09 P 〈0.05）.At the eight week,with the higher of executive function and total scores,the attention and delayed recall were higher than those of the control group（t =2.63,2.58,P 〈0.01）.At the end of the 12th week,the executive function,attention,delayed recall,and total scores were higher in study groups than those in control groups（t =2.05,2.38,2.57,3.11,P 〈0.05）.Conclusion：The treatment of schizophrenia patients with drug therapy combined with group cognitive behavior therapy has good effect in the improvement of psychiatric symptoms and cognitive function recovery