团体认知行为治疗对精神分裂症顽固性幻听的疗效研究

Effect of Group Cognitive Behavioral Therapy on Intractable Auditory Hallucinations in Schizophrenia

目的 研究分析团体认知行为治疗对精神分裂症顽固性幻听的疗效。方法 简单随机选取2021年9月—2022年6月龙岩市第三医院收治的诊断为精神分裂症顽固性幻听者50例作为研究对象,按照治疗方法的不同分为两组,每组25例,均服用抗精神病药物3个月,幻听症状未见明显改善。对照组采用常规认知指导,研究组采用系统团体认知行为治疗。两组以阳性和阴性症状量表、临床疗效总印象量表、不良情绪等行疗效评定。结果 治疗后,两组各项阳性和阴性症状量表、临床疗效总印象量表、汉密尔顿焦虑量表、汉密尔顿抑郁量表、自杀风险、暴力风险均低于治疗前,且研究组低于对照组,而日常生活能力量表评分高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05)。研究组总有效率为96.00%,高于对照组的68.00%,差异有统计学意义(χ^(2)=4.878,P<0.05)。结论 精神分裂症顽固性幻听者配合团体认知行为,可改善症状表现,减轻焦虑、抑郁不良情绪,降低自杀风险与暴力风险,提升日常生活能力,获得理想效果。

Objective To observe the therapeutic effect of group cognitive behavioral therapy on intractable auditory hallucinations in schizophrenia.Methods 50 patients diagnosed as intractable auditory hallucinations of schizophrenia admitted to the Third Hospital of Longyan City from September 2021 to June 2022 were simply and randomly selected as the study objects,and were divided into two groups according to different treatment methods,with 25 cases in each group.All patients took antipsychotic drugs for 3 months,and the symptoms of auditory hallucinations did not improve significantly.The control group received conventional cognitive instruction and the study group received systematic group cognitive behavioral therapy.The two groups were evaluated by Positive and Negative Symptom Scale,of Clinical Global Impression Scale and adverse mood.Results After treatment,all the Positive and Negative Symptom Scale,Clinical Global Impression Scale,Hamilton Anxiety Scale,Hamilton Depression Scale,suicide risk and violence risk in both groups were lower than before treatment,and the study group was lower than the control group,while the Activity of Daily Living score was higher than before treatment,and the study group was higher than the control group,the difference was statistically significant(P<0.05).The total effective rate of the study group was 96.00%,higher than that of the control group(68.00%),and the difference was statistically significant(χ^(2)=4.878,P<0.05).Conclusion In patients with persistent auditory hallucinations with group cognitive behavior,it can improve symptoms,reduce anxiety,depression,reduce the risk of suicide and violence,improve the ability of daily living,and obtain ideal results.