基于IMB模型的团体认知行为疗法在精神分裂症顽固性幻听患者中的应用  

Application of group cognitive-behavioral therapy based on IMB model in schizophrenia patients with refractory auditory hallucinations

作　　者：陈小峰 王小兰 傅薛标 李文雪 王雪莲 简方 CHEN Xiao-feng;WANG Xiao-lan;FU Xue-biao;LI Wen-xue;WANG Xue-lian;JIAN Fang(First Department of Psychiatry,the Third Hospital of Longyan City,Longyan 364000,Fujian,CHINA)

机构地区：[1]龙岩市第三医院精神一科,福建龙岩364000

出　　处：《海南医学》2024年第11期1590-1594,共5页Hainan Medical Journal

基　　金：福建省龙岩市科学技术项目(编号:2021LYF17051)。

摘　　要：目的探讨基于信息-动机-行为技巧模型(IMB模型)的团体认知行为疗法在精神分裂症顽固性幻听患者中的应用效果。方法选择2021年10月至2023年10月龙岩市第三医院收治的50例精神分裂症顽固性幻听患者展开研究,按随机数表法分为对照组和观察组各25例。对照组患者给予常规干预,观察组患者给予基于IMB模型的团体认知行为疗法干预。两组患者均干预至出院,比较两组治疗前及出院时的阳性与阴性症状量表(PANSS)、幻听视觉量表(AHRS)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)及精神分裂症患者生活质量量表(SQLS)各项评分的变化;患者出院时,统计两组患者的满意率。结果治疗后,两组患者的PANSS评分降低,且观察组患者的阴性症状、阳性症状、精神病理、总分评分分别为(13.29±2.09)分、(8.21±1.20)分、(17.31±2.41)分、(40.89±4.21)分,明显低于对照组的(16.28±2.03)分、(10.28±1.44)分、(20.45±2.50)分、(46.98±4.72)分,差异均有统计学意义(P<0.05);治疗后,两组患者的AHRS、HAMA、HAMD评分均降低,且观察组患者的上述评分分别为(15.28±2.11)分、(42.21±3.10)分、(52.18±4.09)分,明显低于对照组的(19.32±2.42)分、(46.33±2.98)分、(56.28±4.57)分,差异均有统计学意义(P<0.05);治疗后,两组患者的SQLS评分均降低,且观察组患者的心理社会、精力和动机、症状和副作用评分为(12.09±2.41)分、(23.28±3.09)分、(11.20±2.37)分,明显低于对照组的(15.28±2.18)分、(29.35±3.41)分、(14.28±2.42)分,差异均有统计学意义(P<0.05);观察组患者出院时的满意率为94.00%,明显高于对照组的72.00%,差异有统计学意义(P<0.05)。结论基于IMB模型的团体认知行为疗法可改善患者的症状及顽固性幻听,减轻焦虑、抑郁不良情绪,提高生活质量,患者的满意率高。Objective To explore the application effect of group cognitive-behavioral therapy based on the information motivation behavioral skills(IMB)model in schizophrenia patients with refractory auditory hallucinations.Methods Fifty schizophrenia patients with refractory auditory hallucinations admitted to the Third Hospital of Longyan City from October 2021 to October 2023 were randomly divided into two groups using a random number table method,with 25 cases in each group.Patients in the control group received routine intervention,while those in the observation group received group cognitive-behavioral therapy intervention based on the IMB model.Both groups of patients were intervened until discharge,and the Positive and Negative Symptom Scale(PANSS),Auditory Hallucination Visual Scale(AHRS),Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD),and Schizophrenic Quality of Life Scale(SQLS)scores before and at discharge were compared between the two groups.The satisfaction rates of the two groups of patients were calculated at discharge.Results After treatment,the PANSS scores of both groups decreased,and the scores of negative symptoms,positive symptoms,psychopathology,and total score of the observation group were(13.29±2.09)points,(8.21±1.20)points,(17.31±2.41)points,and(40.89±4.21)points,which were significantly lower than(16.28±2.03)points,(10.28±1.44)points,(20.45±2.50)points,and(46.98±4.72)points of the control group(P<0.05).After treatment,the AHRS,HAMA,and HAMD scores of both groups decreased,and the above scores in the observation group were(15.28±2.11)points,(42.21±3.10)points,and(52.18±4.09)points,which were significantly lower than(19.32±2.42)points,(46.33±2.98)points,and(56.28±4.57)points in the control group,with statistically significant differences(P<0.05).After treatment,the SQLS scores of both groups decreased,and the psychological,social,energy,motivation,symptoms,and side effects scores of the observation group were(12.09±2.41)points,(23.28±3.09)points,(11.20±2.37)points,which

关 键 词：精神分裂症 顽固性幻听 信息-动机-行为技巧模型 团体认知行为疗法 生活质量 满意率 

分 类 号：R749.3[医药卫生—神经病学与精神病学]