计算机认知矫正治疗对首发精神分裂症患者预后的影响

Effect of computerized cognitive remediation therapy on the prognosis of patients with first-episode schizophrenia

目的探讨计算机认知矫正(CCRT)治疗对首发精神分裂症预后的影响。方法选取2018年1~6月我院收治的80例首发精神分裂症患者作为研究对象,按随机数字表法将其分为两组,每组各40例。对照组患者实施规范抗精神病药物治疗、普通工娱康复治疗及心理治疗,治疗组患者在对照组的治疗基础上同时开展CCRT治疗。比较两组患者的精神症状缓解、认知缺陷恢复及病耻感变化状况。结果治疗前及治疗3个月,两组患者的阳性和阴性症状量表(PANSS)评分比较,差异无统计学意义(P>0.05);治疗6个月,治疗组患者的PANSS评分低于对照组,差异有统计学意义(P<0.05);两组患者治疗3、6个月的PANSS评分均低于治疗前,差异有统计学意义(P<0.05)。治疗前,两组患者的神经心理状态评定量表(rBANS)评分比较,差异无统计学意义(P>0.05);治疗组患者治疗3、6个月的即刻记忆、视觉广度、言语功能、注意、延时记忆评分及rBANS总分均高于对照组,差异有统计学意义(P<0.05);两组患者治疗3、6个月的即刻记忆、视觉广度、言语功能、注意、延时记忆评分及rBANS总分均高于治疗前,差异有统计学意义(P<0.05)。治疗前,两组患者的病耻感评分比较,差异无统计学意义(P>0.05);治疗组患者治疗3、6个月的病耻感评分低于对照组,差异有统计学意义(P<0.05);两组患者治疗3、6个月的病耻感评分均低于治疗前,差异有统计学意义(P<0.05)。结论对首发精神分裂症实施计算机认知矫正治疗,可以有效改善患者的认知缺陷,减轻病耻感,促进康复过程中精神症状的缓解。

Objective To investigate the effect of computerized cognitive remediation therapy(CCRT)on the prognosis of patients with first-episode schizophrenia.Methods A total of 80 first-episode schizophrenia patients addmited to our hospital from January to June 2018 were selected and divided into two groups according to the random number table method,with 40 cases in each group.Patients in the control group were treated with standardized antipsychotic treatment,rehabilitation treatment for common work and entertainment,and psychological treatment.Patients in the experimental group were treated with CCRT treatment on the basis of the treatment of the control group.The mental symptom relief,cognitive defect recovery and stigma change of the two groups were compared.Results There were no statistically significant differences between the positive and negative symptom scale(PANSS)scores of the two groups before treatment and at 3 months after treatment(P>0.05).The PANSS score of the experimental group was lower than that of the control group at 6 months after treatment,and the difference was statistically significant(P<0.05).The PANSS scores of the two groups at 3 and 6 months after treatment were lower than those before treatment,and the differences were statistically significant(P<0.05).There was no statistically significant difference in rBANS score between the two groups before treatment(P>0.05).The immediate memory,visual span,verbal function,attention,delayed memory scores and rBANS total score of patients in the experimental group were higher than those in the control group,and the differences were statistically significant(P<0.05).The immediate memory,visual span,verbal function,attention,delayed memory scores and rBANS total score of the two groups at 3 and 6 months after treatment were higher than those before treatment,and the differences were statistically significant(P<0.05).There was no statistically significant difference in stigma score between the two groups before treatment(P>0.05).The stigma scores of the experimental group at 3 and 6 months after treatment were lower than those of the control group,and the differences were statistically significant(P<0.05).Stigma score in the two groups at 3 and 6 months after treatment were lower than those before treatment,and the differences were statistically significant(P<0.05).Conclusion Computerized cognitive remediation therapy for first-episode schizophrenia can significantly improve the cognitive defects of patients,effectively reduce stigma,and promote the remission of psychiatric symptoms in the process of rehabilitation.