认知行为疗法在精神病康复治疗中的应用  

Application of cognitive behavioral therapy in the rehabilitative treatment of mental diseases

作　　者：张永莉[1] 孟波[2] 赵贵芳[1] 

机构地区：[1]山东省精神卫生中心精神科,山东省济南市250014 [2]山东经济学院外语系,山东省济南市250014

出　　处：《中国临床康复》2005年第28期223-225,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:分析认知行为疗法在精神分裂症、抑郁症等精神病康复治疗中的应用及其治疗效果。资料来源:应用计算机检索Medline数据库1990-01/2004-12期间的相关文章,检索词“Schizophrenia,Affectivedisorder,CognitiveBehavioralTherapyNursing”,限定文章语言种类为English。同时应用计算机检索中国期刊全文数据库1994-01/2004-12期间的相关文章,检索词为″精神分裂症;情感障碍,精神病性,认知行为疗法″,限定文章语言种类为汉语。并阅读有关医学心理学,护理心理学方面的著作。资料选择:对资料进行初审,排除重复研究和Meta分析类文章,选取有关认知行为疗法在精神分裂症及情感性精神障碍康复治疗中应用的研究文章。资料提炼:共收集到48篇有关认知行为疗法在精神病康复治疗中的应用的文章,排除重复或类似研究,纳入12篇,其中有关认知行为疗法治疗精神分裂症7篇,治疗精神分裂症继发抑郁3篇,治疗抑郁症2篇。资料综合:认知行为疗法建立在认知理论、学习理论基础上,导致一个人行为和情绪障碍的根本原因,不是事件本身而是一个人对事件的看法和评价。通过认知技术和行为技术,帮助患者自主思维,提高认知水平,改变极端信念,使患者发现、分析问题并鼓励其积极解决。在治疗中患者是叙述者、学习者及学习过程的执行者,治疗师的任务是努力促使患者在抛弃以前想法的同时学会一种新的应对方式,采用问询、引导式教育和家庭作业等方法,洞察患者的意念和想法,鼓励其用做作业的方式强化治疗,重点不在于纠正患者的不良行为本身,要使患者能够逐步修正其不合理的思维和理念,认识到自己的精神病症状,结合一定的行为训练,改变他们对客观事件的情绪及行为反应。认知行为疗法可能具有通过神经生物学机制而达到治疗的目的,与其他常规或药物治疗相比,该疗法操作简便,OBJECTIVE： To analyze the application of cognitive behavioral therapy in the rehabilitation of schizophrenia and depression, and investigate the therapeutic effects. DATA SOURCES： A computer-based search of Medline database was undertaken to identify relevant articles published in English between January 1990 and December 2004 by using the keywords of “schizophrenia, affective disorder, cognitive behavioral therapy, nursing”. The relevant Chinese articles published from January 1994 to December 2004 with the keywords of “schizophrenia, affective disorder, cognitive behavioral therapy, nursing”. Works about medical psychology and nursing psychology were also read. STUDY SELECTION： All papers were checked firstly, the repetitive studies and Meta analysis were excluded, and the articles about the application of cognitive behavioral therapy in the rehabilitation of schizophrenia and affective disorder were selected, DATA EXTRACTION： Of the 48 collected articles about the application of cognitive behavioral therapy in psychiatry, 12 were in accordance with the inclusive criteria, including 7 about the cognitive behavioral therapy in the treatment of schizophrenia, 3 about schizophrenia-induced depression, and 2 about depression. DATA SYNTHESIS： Based on cognitive theory, cognitive behavioral therapy is effective in the treatment of depression in affeetive disorder, depression after schizophrenia and schizophrenia by adopting methods of inquiry, instructive education and homework assignment, it can soothe symptoms, cut down on recurrence and better redeem the inadequacy of simple medication. CONCLUSION： Cognitive behavioral therapy has active effect on the degree and speed of the positive symptoms of patients, can reduce the remaining symptoms and contribute to the recovery of insight. It is also helpful to change psychotic thinking, promote the treatment and recovery of psychosis. Cognitive behavioral therapy is well practicable and applicable in psychotherapy.

关 键 词：精神分裂症 情感障碍 精神病性 认知 行为疗法 

分 类 号：R749.05[医药卫生—神经病学与精神病学]