内观认知疗法对慢性精神分裂症患者抑郁症状和睡眠质量的随机对照试验  

A randomized controlled trial of Naikan cognitive therapy on depressive symptoms and sleep quality in patients with chronic schizophrenia

作　　者：江珊 王怡[1] 于文彦 王宇暄 王书哲 毛富强[1] JIANG Shan;WANG Yi;YU Wenyan;WANG Yuxuan;WANG Shuzhe;MAO Fuqiang(Department of Mental Health and Psychology,Tianjin Medical University,Tianjin 300070,China)

机构地区：[1]天津医科大学精神卫生与心理学系,天津300070

出　　处：《中国心理卫生杂志》2025年第4期321-326,共6页Chinese Mental Health Journal

基　　金：司法部法治建设与法学理论研究部级科研项目——内观戒毒社区康复模式构建及肠道菌群效果评估(JDJZ202201)。

摘　　要：目的:探讨内观认知疗法联合药物治疗对慢性精神分裂症患者抑郁症状和睡眠质量的疗效。方法:纳入患者符合以下标准,即符合ICD-10精神分裂症诊断标准、病程≥2 a、病情稳定且处于抗精神病药物维持治疗中、存在抑郁症状和睡眠质量问题、既往2个月未服用抗抑郁剂。入组的64例患者,随机分为内观认知疗法联合药物治疗组(NCT组,n=32)和心理健康宣教联合药物治疗组(MEC组,n=32),共治疗6天,每组各脱落2例。使用贝克抑郁量表第2版(BDI-II)及匹兹堡睡眠质量指数(PSQI)评定抑郁症状和睡眠质量。结果:治疗后,NCT组BDI-II得分的差值(治疗后得分-治疗前得分)低于MEC组(P<0.001),PSQI总分差值也低于MEC组(P<0.001)。结论:在常规药物治疗的基础上叠加内观认知疗法可以改善慢性精神分裂症患者的抑郁症状和睡眠质量。Objective:To investigate the efficacy of Naikan cognitive therapy(NCT)combined with medication in improving depressive symptoms and sleep quality in patients with chronic schizophrenia.Methods:Patients were included if they met the following criteria:diagnosed with schizophrenia based on ICD-10 criteria,a disease course of≥2 years,stable condition under maintenance antipsychotic medication,presence of depressive symptoms and sleep quality issues,and no use of antidepressants in the past two months.A total of 64 eligible patients were randomly assigned to the NCT group(n=32)or the mental health education(MEC)group(n=32).The intervention lasted 6 days,with 2 patients from each group dropping out.The Beck Depression Inventory-II(BDI-II)and Pittsburgh Sleep Quality Index(PSQI)were used to assess depressive symptoms and sleep quality.Results:After the intervention,the BDI-II score difference(post-treatment score minus pre-treatment score)in the NCT group was significantly lower than that in the MEC group(P<0.001).Similarly,the PSQI total score difference was also lower in the NCT group compared to the MEC group(P<0.001).Conclusion:Adding Naikan cognitive therapy to routine medication treatment can effectively improve depressive symptoms and sleep quality in patients with chronic schizophrenia.

关 键 词：内观认知疗法 精神分裂症 抑郁症状 睡眠质量 

分 类 号：R749.3[医药卫生—神经病学与精神病学] R339.63[医药卫生—临床医学]