认知行为干预对社区慢性精神分裂症患者康复疗效评估  

Efficacy of cognitive-behavioral intervention on rehabilitation of chronic schizophrenics in community

作　　者：方文莉[1] 陶华[1] 季卫东[1] 王珺[1] 郑宏[1] 顾美铮[1] 黄佩蓉[1] 张郦[1] 陈浩[1] 蔡军[2] 

机构地区：[1]上海市长宁区精神卫生中心,200335 [2]上海交通大学医学院附属精神卫生中心

出　　处：《上海精神医学》2010年第1期26-29,共4页Shanghai Archives of Psychiatry

基　　金：上海预防精神医学重点学科资助项目(05III028-16);长宁区卫生局科研项目(2006D4S06001)

摘　　要：目的探讨认知行为干预对社区慢性精神分裂症患者的康复疗效。方法将103例日间康复照料机构的慢性精神分裂症患者分成两组,治疗组予以个体或团体认知行为干预,对照组仅予一般的社区随访和疾病指导。采用阳性与阴性症状综合征量表(PANSS)、自知力与治疗态度问卷(ITAQ)、Morningside康复状态量表(MRSS)、社会功能缺陷筛选量表(SDSS)分别于治疗前,治疗1年、2年末进行评定。结果采用认知行为干预的患者阴性量表分降低(t=2.47,P=0.04);MRSS症状行为表现因子分明显下降(t=3.35,P=0.01),依赖性因子分低于对照组(t=3.12,P=0.01),患者的康复状态有进步;研究组的SDSS分值明显低于对照组(t=4.52,P<0.01),而ITAQ分值明显高于对照组(t=2.00,P=0.05),社会功能缺陷程度明显减轻。结论认知行为干预对社区慢性精神分裂症患者的康复有促进作用。Objective： To investigate the efficacy of cognitive -behavioral intervention on rehabilitation of chronic schizophrenics in community. Methods： One - hundred and three schizophrenic patients in community rehabilitation day services were divided into two groups, receiving either individual/group cognitive -behavioral intervention or general community follow - up and health education. Positive and negative syndrome scale （PANSS）, insight and treatment attitudes questionnaire （ITAQ）, Morningside rehabilitation status scale （MRSS）, and social disability screening schedule （SDSS） were used to assess the two groups at pro - therapy, 1 year after intervention, and 2 years after intervention. Results： Patients treated with cognitive - behavioral intervention had statistically significant improvement on the score of negative syndrome scale （ t = 2.47, P = 0. 04）. The cognitive - behavioral intervention statistically significantly reduced the symptoms and abnormal behavior factor scores of Morningside rehabilitation status scale （ t = 3.35, P = 0. 01 ）. And the dependence factor scores were statistically significantly lowert than control group as well（t = 3.12, P = 0.01 ）. All patients improved in rehabilitation status, with SDSS scores statistically lower in intervention group than in control group（t = 4.52, P 〈 0. 01 ）, and ITAQ scores statistically higher in intervention group than in control group（t =2.00,P = 0.05 ）. All patients improved in the degree of social disability. Conclusion： Cognitive- behavioral intervention can enhance the level of rehabilitation in chronic schizophrenics in community.

关 键 词：认知行为治疗 慢性精神分裂症 康复 

分 类 号：R749.3[医药卫生—神经病学与精神病学] R749.92[医药卫生—临床医学]