鼓圈治疗结合虚拟现实技术下社交技能训练对精神分裂症阴性症状及社交技能的影响

Effects of drum circle therapy combined with social skills training under virtual reality technology on negative symptoms and social skills in schizophrenia

目的分析鼓圈治疗结合虚拟现实技术下社交技能训练对老年精神分裂症患者阴性症状、认知功能、社交技能的影响。方法采用前瞻性研究法,纳入丽水市第二人民医院精神科2020年2月至2021年12月收治的90例精神分裂症患者。随机数字表法分为3组,每组30例,A组行常规康复治疗,B组在A组的基础上加用鼓圈治疗,C组在B组的基础上增加虚拟现实技术下社交技能训练。观察时间点为治疗前,治疗4周、8周、12周,评估工具包括社交技能评定目录(social skills checklist,SSC)、改善精神分裂症认知(measurement and treatment research to improve cognition in schizophrenia,MATRICS)成套神经认知测验(MATRICS consensus cognitive battery,MCCB)、阳性和阴性症状量表(positive and negative syndrome scale,PANSS),PANSS仅计算其中的阳性症状和阴性症状评分。结果治疗前3组患者SSC分值比较差异无统计学意义(P>0.05);治疗4周、8周、12周时3组患者的SCC分值均降低,3组分值比较为C组<B组<A组,差异有统计学意义(P<0.05)。治疗前3组患者MCCB中的神经认知和社会认知分值比较差异无统计学意义(P>0.05);治疗4周、8周、12周时3组患者的神经认知和社会认知分值均升高,3组分值比较为C组>B组>A组,差异有统计学意义(P<0.05)。治疗前至治疗12周,3组患者的PANSS中阳性症状分值比较差异均无统计学意义(P>0.05);治疗前3组患者PANSS中阴性症状分值差异无统计学意义(P>0.05),治疗4周、8周、12周时3组患者阴性症状分值均降低,3组分值比较为C组<B组<A组,差异有统计学意义(P<0.05)。结论鼓圈治疗结合虚拟现实社交技能训练能进一步改善老年精神分裂症患者的阴性症状,提高患者的神经认知功能、社会认知功能和社交技能。

Objective To analyze the effects of virtual reality social skills training combined with drum circle therapy on negative symptoms,cognitive function and social skills of elderly patients with schizophrenia.Methods Using the prospective study method,90 patients with schizophrenia admitted to the Department of Psychiatry of Lishui Second People’s Hospital from February 2020 to December 2021 were included.There were 30 cases in each group.Group A received routine rehabilitation treatment;Group B was treated with drum circle on the basis of group A;Group C added social skills training under virtual reality technology on the basis of group B.The social skills checklist(SSC)and measurement and treatment research to improve cognition in schizophrenia(MATRICS)consensus cognitive battery(MCCB)were observed before treatment and around 4,8 and 12 weeks after treatment.MCCB score,positive and negative syndrome scale(PANSS)score.Results Before treatment,there was no significant difference in SSC scale scores among the three groups(P>0.05),SCC scores of the three groups were decreased at 4,8 and 12 weeks of treatment,and SCC scores of the three groups were compared with group C<group B<group A,with statistical significance(P<0.05).There was no significant difference in neurocognitive and social cognitive scores in the MCCB scale of the three groups before treatment(P>0.05),and the above scores of the three groups were increased at 4,8 and 12 weeks of treatment,and the neurocognitive and social cognitive scores of the three groups were in group C>group B>group A,with statistical significance(P<0.05).There was no significant difference in the total score of positive symptoms of PANSS among the three groups from before treatment to 12 weeks of treatment(P>0.05).There was no statistically significant difference in the total negative symptom score of PANSS among the three groups before treatment(P>0.05),and the total negative symptom score of the 4,8 and 12 week treatment groups was compared with group C<group B<group A,with statistical significance(P<0.05).Conclusion Drum circle therapy combined with virtual reality social skills training can further improve the negative symptoms of elderly schizophrenia and improve cognitive function and social skills.