歌曲回忆技术对慢性精神分裂症患者阴性症状的干预效果

Effects of song reminiscence on negative symptoms in patients with chronic schizophrenia

目的:探究音乐治疗中的歌曲回忆技术对慢性精神分裂症患者阴性症状的干预作用。方法:选取北京回龙观医院的慢性精神分裂症住院患者100例,根据样本量估算进行特质匹配,其中61人为歌曲组,39人为对照组。歌曲组接受精神科常规治疗合并歌曲回忆12周,对照组接受精神科常规联合特殊工娱治疗12周。用阴性症状量表(SANS)、阳性阴性症状评定量表(PANSS)以及护士观察量表(NOSIE)分别于基线、12周干预后对临床症状和行为表现进行盲法评定。结果:重复测量方差分析结果显示,12周干预后歌曲组PANSS总分及阴性症状、复合量表分,SANS总分及情感平淡或迟钝、意志缺乏、兴趣社交缺乏、注意障碍、分量表综合评价总分均低于对照组(均P<0.05);而NOSIE的社会兴趣、个人整洁、总积极因素和病情总估计得分均高于对照组(均P<0.05)。结论:音乐治疗中的歌曲回忆技术对于慢性精神分裂症患者的阴性症状和行为表现有一定改善作用。

Objective:To evaluate the effect of song reminiscence of music therapy on clinical effect and behavioral performance in patients with chronic schizophrenia.Methods:Totally 100 patients with chronic schizophrenia from Beijing Huilongguan Hospital were assigned into the song reminiscence group(n=61)and the control group(n=39)according to the sample size calculation and trait matching.The song group was given previous regular treatment plus song reminiscence for 12 weeks,while the control group was given previous regular treatment plus occupational and recreational therapy for 12 weeks.All patients were blind assessed with Positive and Negative Syndrome Scale(PANSS),Scale of Assessment Negative Symptoms(SANS)and Nurses’Observation Scale for Inpatient Evaluation(NOSIE)at base line and at the end of the 12-week intervention to evaluate the improvement of clinical effect and behavioral performance.Results:The repeated-measures analysis of variance(ANOVA)showed that after 12 week intervention,the PANSS total scores and factor scores of negative scale and complex scale,and the SANS total scores,composite scores and factor scores of affective flattening or blunting,avolition-apathy,anhedonia-asociality and attentional impairmentwere lower in the song reminiscence group than in the control group(Ps<0.05),while the NOSIE global scores,total positive scores,and factor scores of social interest,personal neatness were higher in the song reminiscence group than in the control group(Ps<0.05).Conclusion:It suggests that song reminiscence of music therapy could possibly improve negative symptoms and behavioral performance in patients with chronic schizophrenia.