认知行为干预对精神分裂症患者一级亲属分裂质个体阴性症状、抑郁和认知功能的影响  

Cognitive behavioral intervention of schizotypy individuals in first-degree relatives of patients with schizophrenia

作　　者：沈芳[1] 邵华芹[1] 汤路瀚 邢葆平[1] 

机构地区：[1]浙江省立同德医院精神科,杭州310012

出　　处：《浙江医学》2016年第20期1666-1670,共5页Zhejiang Medical Journal

基　　金：浙江省医药卫生科技计划项目(2013KYA032)

摘　　要：目的通过对精神分裂症一级亲属分裂质个体进行筛查和干预,了解该人群个体的阴性症状、情感和认知功能的变化及干预的影响。方法将精神分裂症患者筛查并符合纳入标准的一级亲属分裂质个体136例,按随机数字表法分为研究组59例和对照组77例,研究组实施为期12周的认知行为干预(CBT),对照组仅做长期随访,并在CBT前、CBT后4、8、12周、6个月及1年采用阴性症状量表(SANS)、抑郁自评量表(SDS)和威斯康星卡片分类测验(WCST)进行评估比较。结果两组CBT前SANS、SDS评分及WCST各因子分均无统计学差异(均P>0.05)。研究组SANS评分随随访时间延长而逐渐下降,CBT后8、12周、6个月及1年时与CBT前比较差异均有统计学意义(均P<0.05);与对照组比较,8周起各时点均有统计学差异(均P<0.05)。研究组SDS评分CBT后8、12周、6个月及1年时较CBT前均明显下降(均P<0.05);与对照组比较,4周起各时点均有统计学差异(均P<0.05)。研究组WCST持续和非持续错误CBT后12周、6个月及1年与CBT前比较差异均有统计学意义(均P<0.05);与对照组比较,研究组总反应数及错误反应数CBT后8、12周、6个月及1年时差异均有统计学意义(均P<0.05),其余各因子分12周或6个月起差异均有统计学意义(均P<0.05)。结论 CBT能快速有效改善精神分裂症患者一级亲属分裂质个体的精神病性思维,减少其阴性症状,并可持续改善患者认知神经心理功能。Objective To assess the cognitive behavioral intervention of schizotypy individuals in the first-degree relativesof schizophrenic patients. Methods One hundred and thirty six first-degree relatives of schizophrenic patients with schizotypywere randomly divided into study group （n=59） and control group （n=77）. The individuals in study group received cognitivebehavior intervention for 12 weeks and those in control group were only followed-up. The Scale of Assessment of NegativeSymptoms （SANS）, Self Rating Depression Scale （SDS） and Wisconsin Card Sorting Test （WCST） were used for assessment after4, 8, 12 weeks, 6 months and 1 year after intervention. Results There were no significant differences in SANS, SDS and WCSTscores between two groups before intervention （P〉0.05）. The SANS scores in study group tended to gradually decline with theextension of follow-up time, compared to that before intervention the scores in 8, 12 weeks, 6 months and 1 year after interventionwere significantly decreased （P〈0.05）, and the scores in study were significantly lower than those in control group at all timepoints after 8 weeks of intervention （P〈0.05）. The SDS score in study group tended to gradually decline in 8 weeks, 12 weeks, 6months and 1 year compared to before intervention（P〈0.05）, compared to the control group, the scores in study group in all timepoints after 4 weeks of intervention were significantly decreased （P〈0.05）. There were significant differences in WCST scores ofcontinuous and non continuous errors in study group between those before intervention and 12 weeks, 6 months, 1 year afterintervention （P〈0.05）, there were significant differences in total number of reactions and number of error reactions in 8, 12 weeks,6 months and 1 year between two groups （P〈0.05）, for other factors the significant differences were observed in 12 weeks or 6months between control and study groups （P〈0.05）. Conclusion Cognitive behavioral intervention can effectively imp

关 键 词：】认知行为干预 分裂质 阴性症状 抑郁 认知功能 

分 类 号：R749.3[医药卫生—神经病学与精神病学]