计算机认知矫正治疗联合社交技能训练对精神分裂症患者认知功能的疗效

Effect of computerized cognitive remediation therapy combined with social skills training on cognitive function in schizophrenic patients

目的探讨计算机认知矫正治疗联合社交技能训练改善精神分裂症患者认知功能的效果。方法2017年1—12月选取168例慢性精神分裂症患者随机分为干预组(入组82例,完成79例)和对照组(入组86例,完成84例),分别接受12周的计算机认知矫正治疗联合社交技能训练和计算机认知矫正治疗12周,并随访12个月。采用阳性与阴性症状量表(PANSS)、精神分裂症认知功能成套测验中文版(MCCB)及个人和社会功能量表(PSP)在基线、12周末及随访12个月末分别进行评估。结果(1)治疗12周末,干预组PANSS的认知因子分明显低于对照组(t=-4.22,P<0.001);随访12个月末时干预组的阴性因子分及认知因子分均明显低于对照组(t=-2.36,P=0.020;t=-5.91,P<0.001)。随访12个月末,干预组的PANSS总分与基线比较差异有统计学意义(t=3.41,P<0.001),但与对照组比较差异无统计学意义(t=1.57,P=0.119)。(2)干预组在12个月末的PSP总分、神经认知功能总分和社会认知分均高于对照组,两组比较差异均有统计学意义(P<0.05)。结论计算机认知矫正治疗联合社交技能训练能够显著改善精神分裂症患者的认知功能,从而有效促进社会功能恢复。

Objectives To investigate the effects of computerized cognitive remediation therapy combined with social skills training on cognitive function in schizophrenic patients. Methods From January to December 2017, totally 168 patients with chronic schizophrenia were randomly divided into the intervention group (82 patients enrolled, 79 patients retained) and the control group (86 patients enrolled, 84 patients retained). They received a 12-week computerized cognitive remediation therapy combined with social skills training and only computer cognitive remediation therapy, respectively. They were followed up for 12 months. The Positive and Negative Symptoms Scale (PANSS), the Chinese version of the MATRICS Consensus Cognitive Battery (MCCB), and the Personal and Social Performance Scale (PSP) were evaluated at baseline, at the end of 12 weeks, and at the end of 12 months. Results (1) At the end of the 12-week treatment, the cognitive factor scores of the PANSS scale in the intervention group were significantly lower than those in the control group (t=-4.22, P< 0.001). The negative factor scores and cognitive factor scores in the intervention group at the end of 12 months were significantly lower than the control group (t=-2.36,P=0.020;t=-5.91,P< 0.001). At the end of 12 months, the PANSS total score of the intervention group was significantly different from the baseline (t=3.41,P< 0.001), but there was no significant difference compared with the control group (t=1.57, P=0.119).(2) There were significant differences in PSP total score, total neurocognitive function score and social cognition score between the intervention group and the control group at the end of 12 months (P< 0.05). Conclusions Computerized cognitive remediation therapy combined with social skills training can significantly improve the cognitive function of patients with schizophrenia, thus effectively promoting the recovery of social function.