计算机辅助认知矫正治疗对康复期精神分裂症患者认知功能、自尊水平及社会功能的影响

Effect of Computer-assisted Cognitive Remediation Therapy on the Improvement of Cognitive Function,Level of Self-esteem and Social Performance in Schizophrenia Patients during Recovery Period

目的探讨计算机辅助认知矫正治疗对康复期精神分裂症患者的认知功能、自尊水平及社会功能的干预效果。方法选取2016年3—12月就诊于浙江省杭州市第七人民医院的精神分裂症患者86例为研究对象。采用随机数字表将患者分为对照组和干预组,每组各43例。对照组给予原剂量的常规药物治疗;干预组在对照组的基础上给予计算机辅助认知矫正治疗,治疗时间均持续8周。分别于干预前和干预8周后采用威斯康星卡片分类测验(WCST)、连线测验(TMT)、中国修订韦氏成人智力量表(WAIS-RC)中的数字广度及数字符号测验、自尊量表(SES)、个人和社会功能量表(PSP)评估患者的认知功能、自尊水平及社会功能。结果干预前,两组患者WCST总测验次数、正确分类数、持续错误数、随机错误数、分类完成数、连线时间A、连线时间B、数字广度得分、数字符号得分比较,差异无统计学意义(P>0.05)。干预后,干预组患者WCST总测验次数、持续错误数、随机错误数小于对照组,正确分类数大于对照组,连线时间A、连线时间B短于对照组,数字广度得分高于对照组,差异有统计学意义(P<0.05);分类完成数、数字符号得分比较,差异无统计学意义(P>0.05)。干预前,两组患者SES、PSP得分比较,差异无统计学意义(P>0.05);干预后,干预组患者SES、PSP得分高于对照组,差异有统计学意义(P<0.05)。结论计算机辅助认知矫正治疗能够有效改善康复期精神分裂症患者的认知功能、自尊水平以及社会功能。

Objective To investigate the effect of computer-assisted cognitive remediation therapy （CCRT） on the improvement of cognitive function,levels of self-esteem and social performance in schizophrenia patients during recovery period.MethodsEighty-six schizophrenia patients during recovery period from Hangzhou Seventh People＇s Hospital,Zhejiang Province,were included during March to December 2016 and were randomized into the CCRT group and control group with 43 in each.The previous conventional drug treatment was continued for 8 weeks in both groups,but 8-week CCRT was given to the CCRT group additionally.Before treatment and at the end of 8-week treatment,Wisconsin Card Sorting Test （WCST）,Trail Making Test（TMT） and digit span and coding subtests of the Wechsler Adult Intelligence Scale-Revised in China（WAIS-RC） were used to measure the cognitive function,Self Esteem Scale（SES） was employed to measure the level of self-esteem,and Personal and Social Performance Scale （PSP） was adopted to examine the social performance of the patients.ResultsCognitive function：There were no significant differences between the groups in terms of WCST performance （including the mean number of trials,correct classification,perseverative errors,non-perseverative errors,and categories achieved）,TMT performance （mean time needed for completing parts A and B of TMT） and scores of digit span and coding subtests of WAIS-RC at baseline （P〉0.05）.After 8-week treatment,the CCRT group demonstrated less mean number of trials,more number of correct classification,perseverative and non-perseverative errors,needed shorter mean time for completing parts A and B of TMT,and achieved higher mean score of digit span subtest（P〈0.05）.However,both groups still showed similar mean number of categories achieved and mean score of coding （P〉0.05）.The level of self-esteem and social performance：The scores of SES and PSP were similar in the two groups at baseline（P〉0.05）,but after 8-week treatment,both of them were significantly higher in the CCRT group compared with the control group （P〈0.05）.ConclusionCCRT can effectively improve the cognitive function,the level of self-esteem and social performance in schizophrenia patients during recovery period.