利培酮联合认知治疗对首发精神分裂症患者认知功能及社会功能的影响  

Influence on cognitive function and social function of risperidone combined with cognitive therapy for first-episode schizophrenia patients

作　　者：黄史青[1] 刘志玲[1] 黎雪松[1] 黄炜[1] 刘锐[1] 朱颖 Huang Shiqing;Liu Zhiling;Li Xuesong;Huang Wei;Liu Rui;Zhu Ying(The Third People's Hospital of Foshan,Foshan 528041,China)

机构地区：[1]佛山市第三人民医院,广东佛山528041

出　　处：《四川精神卫生》2018年第3期236-240,共5页Sichuan Mental Health

基　　金：佛山市卫生和计生局医学科研(20170131)

摘　　要：目的探讨利培酮联合认知治疗对首发精神分裂症患者认知功能的影响并观察出院后的社会功能,为首发精神分裂症的治疗提供参考。方法选取2015年1月-2017年6月在佛山市第三人民医院就诊的符合《国际疾病分类(第10版)》(ICD-10)诊断标准的首发精神分裂症患者100例,采用随机数字表法分为对照组(利培酮治疗)和研究组(利培酮联合认知治疗)各50例,两组均治疗8周。在治疗前及治疗8周后,采用阳性和阴性症状量表(PANSS)、副反应量表(TESS)、韦氏成人智力量表中国修订版(WAIS-RC)及韦氏记忆量表(WMS)分别评定精神症状、不良反应和认知功能。对两组患者进行1年随访,于出院1月及1年后采用个体和社会功能量表(PSP)评定患者的社会功能并追踪出院1年后的复发情况。结果治疗8周后,两组PANSS总评分及各分量表评分均低于治疗前(P均<0.01),但两组PANSS评分差异无统计学意义(P>0.05);两组WAIS-RC及WMS评分均高于治疗前,且研究组WAIS-RC及WMS各项评分均高于对照组,差异均有统计学意义(P<0.05或0.01)。出院1年后,研究组PSP评分高于对照组,差异有统计学意义(P<0.05);研究组复发率低于对照组,差异有统计学意义(χ~2=11.415,P<0.01)。结论利培酮联合认知治疗与单用利培酮对首发精神分裂症患者的精神症状改善效果无差异,但联合治疗对认知功能及社会功能的改善效果优于单用利培酮,且复发率更低。Objective To explore the effects of risperidone combined with cognitive therapy in treatment of first episode schizophrenia on cognitive function and to observe the patients'social function one year after being discharged,so as to provide references on clinical treatment for first-episode schizophrenia.Methods 100 participants were selected from The Third People's Hospital of Foshan,which were diagnosed with first-episode schizophrenia based on International Classification of Diseases,tenth edition(ICD-10)from January 2015 to June 2017.Participants were divided randomly into two groups(50 participants in one group)and the treatment has lasted for 8 weeks.Participants in the control group were treated with risperidone alone while candidates in the research group were treated with risperidone combined with cognitive therapy.Before and 8 weeks after the treatment,Positive and Negative Symptoms Scale(PANSS),Treatment Emergent Symptom Scale(TESS),Wechsler Adult Intelligence Scales,Revised in China(WAIS-RC)and Wechsler Memory Scale(WMS)were applied respectively to assess mental symptoms,adverse reactions and cognitive function.One month and one year after being discharged,Personal and Social Performance Scale(PSP)was used respectively to assess participants'social function and recurrence rate.Results After treatment for 8 weeks,the total PANSS score and scores of each subscale were lower than those before treatment in both groups(all P<0.01),while there was no significant difference in PANSS scores between two groups(P>0.05).The scores of WAIS-RC and WMS were higher than before treatment in both groups,and the scores of WAIS-RC and WMS in research group were higher than those in control group,the difference was statistically significant(P<0.05 or 0.01).According to the results of follow-up study,PSP score of the research group was higher than that of the control group one year after being discharged(P<0.05).The recurrence rate in research group was lower than control group(χ2=11.415,P<0.01).Conclusion There is no diff

关 键 词：利培酮 首发精神分裂症 认知治疗 认知功能 随访 

分 类 号：R749.3[医药卫生—神经病学与精神病学]