心理剧对慢性精神分裂症患者阴性症状的疗效观察

Effect of Psychological Drama for the Negative Symptoms in Patients with Chronic Schizophrenia

目的：探讨心理剧对慢性精神分裂症患者阴性症状的疗效。方法：本院180名慢性精神分裂症患者,病程≥5年,病情稳定,初中以上文化程度,按单双号随机分为心理剧组和对照组各90人。心理剧组开展礼貌礼仪、人际交往、解决问题、换位思考、疏导情绪、亲情连接、改变认知、自我表达和自我认同等不同主题的心理剧表演。30名一批,共三批;每批每周2次,每次90分钟,共8周时间。对照组除不参加心理剧治疗外,其它活动同心理剧组。采用阴性症状评定量表（SANS）评定患者的阴性精神症状;自尊量表（SES）评估自尊水平;住院精神病人社会功能评定量表（SSPI）评估社会功能情况。由两名临床医师分别于入组前,治疗结束时用3个量表对每位患者各评定1次,评定者不参加心理剧治疗。结果：治疗结束时,心理剧组阴性症状总分及情感平淡/迟钝、思维贫乏、意志缺乏、兴趣或社交缺乏、注意障碍等5个分量表减分水平均多于对照组（t=-15.018,-10.639,-12.558,-12.261,-12.419,-17.991;P〈0.001）。社会功能和自尊量表的评分高于对照组,差异具有显著性（t=19.81,3.58;P〈0.001）。结论：心理剧治疗可以改善慢性精神分裂症患者阴性症状,提高自尊和社会功能性的恢复。

Objective：To study the curative effect of the psychological drama in patients of negative symptoms with chronic schizophrenia.Methods：A total of 180 patients with chronic schizophrenia were randomly divided into psychological group and the control group according to the single and double number,each group 90 people.They had a course of disease 5 years or more with a stable condition and junior middle school education.The psychological drama of the different themes were developed in the psychological group for the courtesy and etiquette,interpersonal communication,solving problem,the transpositional consideration,mood channel,the family connection,changed cognition,self-expression and identity.30 cases were treated for a group with a total of three group,which attended two times in one week.Except not attend psychodrama therapy,cases in control group took other activities like the psychological group.Each patient completed the scale for assessment of negative symptoms（SANS）to assess the patient＇s negative mental symptoms,and the self-esteem scale（SES）to assess self-esteem level,and the Scale of Social-Skills for Psychiatric Inpatients（SSPI）to assess social function,by two clinical doctors which did not attended into psychodrama therapy before the division of the group.After the treatment,all the participants completed the three scales again.Results：At the end of treatment,the total of negative symptoms score and emotional insipid/dull,poverty of thought,will lack,lack of interest or social,attention disorders in the psychological group were higher than that of the control group（t=-15.018,-10.639,-12.558,-12.261,-12.419,-17.991;P〈0.001）.The social function and the self-esteem scale score were higher than that of the control group（t=19.81,3.58;P〈0.001）.Conclusion：Psychotherapy drama therapy can improve negative symptoms in patients with chronic schizophrenia and improve the recovery of social function and self-esteem.