团体心理治疗对首发精神分裂症患者认知功能、社会功能及疗效的影响
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摘要
目的探讨团体心理治疗对奥氮平治疗2月的首发精神分裂症患者的认知功能、社会功能及精神症状的影响。方法 100例病例来源于2015年12月—2017年3月在杭州市第七人民医院就诊的精神分裂症患者,按随机数字表法分成研究组(n=50)和对照组(n=50),研究组在药物治疗基础上予8周的团体心理治疗,对照组采用单一药物治疗。于基线、8周末使用WCST评定认知功能,使用PSP评定社会功能,PANSS评定精神症状,并对结果进行分析。结果治疗前,2组间认知功能、社会功能、精神症状差异无统计学意义。团体心理治疗8周后,研究组总应答数、错误应答数、持续错误数、非持续错误数较治疗前减少,正确应答数、完成分类数增多,研究组与对照组相比,总应答数、正确应答数、错误应答数、持续错误数、非持续错误数、完成分类数差异具有统计学意义(P<0.05)。治疗后研究组的PSP总分高于对照组,有益活动、社会关系、自我照料因子分低于对照组,差异具有统计学意义(P<0.05),攻击性因子分组间差异无统计学意义(P>0.05)。治疗后研究组阴性症状分下降,2组间阴性症状分差异有统计学意义(P<0.05)。结论团体心理治疗能有效改善首发精神分裂症患者的认知功能、社会功能及阴性症状。
Objective To investigate the effect of group psychotherapy on cognition,social function and psychiatric symptoms in patients with first-episode schizophrenia administrated with olanzapine for two months. Methods A total of 100 patients were diagnosed with schizophrenia who are in the Seventh People's Hospital of Hangzhou from December,2015 to March,2017 were divided into study group( n = 50) and control group( n = 50) according to random number table. The study group was given 8 weeks group psychotherapy. At baseline,at 8 weeks WCST was used to assess cognitive function,PSP to assess social function,PANSS to assess psychiatric symptoms,and analyze the results. Results Before treatment,there was no significant difference in cognitive function,social function and mental symptoms between the two groups. After8 weeks of group psychotherapy,total response,the number of error response,continuous error and non-continuous error in the study group decreased compared with that before treatment,the number of correct responses and the number of completed classification increased. Compared with the control group,total response,the number of correct responses and the number of incorrect responses. The number of continuous errors,the number of non-continuous errors,the number of completed classification differences were statistically significant( P<0.05). After treatment,the total score of PSP in the study group was higher than that in the control group. The scores of beneficial activities,social relations and self-care factors were lower than those in the control group( P < 0.05),but there was no significant difference between the groups > 0.05. After treatment,the scores of negative symptoms decreased in the study group,and the difference of negative symptoms between the two groups was statistically significant( P<0.05). Conclusion Group psychotherapy can effectively improve cognitive function,social function and negative symptoms in first episode schizophrenia patients.
Objective To investigate the effect of group psychotherapy on cognition,social function and psychiatric symptoms in patients with first-episode schizophrenia administrated with olanzapine for two months. Methods A total of 100 patients were diagnosed with schizophrenia who are in the Seventh People's Hospital of Hangzhou from December,2015 to March,2017 were divided into study group( n = 50) and control group( n = 50) according to random number table. The study group was given 8 weeks group psychotherapy. At baseline,at 8 weeks WCST was used to assess cognitive function,PSP to assess social function,PANSS to assess psychiatric symptoms,and analyze the results. Results Before treatment,there was no significant difference in cognitive function,social function and mental symptoms between the two groups. After8 weeks of group psychotherapy,total response,the number of error response,continuous error and non-continuous error in the study group decreased compared with that before treatment,the number of correct responses and the number of completed classification increased. Compared with the control group,total response,the number of correct responses and the number of incorrect responses. The number of continuous errors,the number of non-continuous errors,the number of completed classification differences were statistically significant( P<0.05). After treatment,the total score of PSP in the study group was higher than that in the control group. The scores of beneficial activities,social relations and self-care factors were lower than those in the control group( P < 0.05),but there was no significant difference between the groups > 0.05. After treatment,the scores of negative symptoms decreased in the study group,and the difference of negative symptoms between the two groups was statistically significant( P<0.05). Conclusion Group psychotherapy can effectively improve cognitive function,social function and negative symptoms in first episode schizophrenia patients.
引文
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[10]陈大春,李艳丽,杨可冰,等.首发未用药精神分裂症患者的认知功能与感觉门控P50的关系[J].中国心理卫生杂志,2015,29(10):733-737.
[11]陈大春,杨可冰,李艳丽,等.首发未用药精神分裂症认知功能及生活技能与临床特征的关系[J].中国神经精神疾病杂志,2015,41(1):26-31.
[12]Zhou Z,Zhu Y,Wang J,et al.Risperidone improves interpersonal perception and executive function in patients with schizophrenia[J].Neuropsychiatr Dis Treat,2016,12(13):101-107.
[13]Yasui-Furukori N,Kaneda A,Sugawara N,et al.Effect of adjunctive treatment with aripiprazole to atypical antipsychotics on cognitive function inschizophrenia patients[J].J Psychopharmacol,2013,26(6):806-812.
[14]Nielsen RE,Levander S,Kjaersdam Telléus G,et al.Second-generation antipsychotic effect on cognition in patients with schizophrenia—a meta-analysis of randomized clinical trials[J].Acta Psychiatr Scand,2015,131(3):185-196.
[15]储文革,陈燕,赵宜生,等.6种抗精神病药对精神分裂症首次发病患者认知功能影响的比较[J].临床精神医学杂志,2015,25(3):197-199.
[16]张敏桥,易鹏程,戴天刚.首发精神分裂症患者的治疗及社会功能改善研究[J].中国农村卫生事业管理,2014,34(6):709-711.
[2]鲁晓波,张建芳,高引莉,等.团体心理治疗对女性精神分裂症患者康复影响研究[J].精神医学杂志,2014,27(5):374-376.
[3]鲁陆,马玉娟,方耀平.团体心理治疗对康复期精神分裂症患者疗效的影响[J].现代医药卫生,2017,33(6):1680-1682.
[4]胡群英,廖梅蓉,尹恕.团体心理治疗改善精神分裂症患者依从性临床研究[J].亚太传统医药,2014,11(10):81-82.
[5]李占敏,李淑芬,李亚静,等.团体心理治疗对住院精神分裂症患者社会功能的影响[J].护理学杂志,2015,30(6):80-83.
[6]张国荣,周桂兰.团体心理干预对康复期精神分裂症50例认知功能的影响[J].中国民族民间医药,2015,5(11):125-127.
[7]郭金枝,刘金同,王文萍,等.住院时间对精神分裂症患者出院后1年内再入院的影响[J].精神医学杂志,2017,30(6):420-423.
[8]王文政,石莹莹,于欣,等.首发精神分裂症、超高危及高危人群的神经认知功能对照研究[J].上海交通医科大学学报(医学版),2016,36(10):1458-1466.
[9]朱丽佳,王志中,贺菲菲,等.焦点解决模式对康复期精神分裂症患者社会功能的影响研究[J].世界最新医学信息文摘,2017,17(45):49-53.
[10]陈大春,李艳丽,杨可冰,等.首发未用药精神分裂症患者的认知功能与感觉门控P50的关系[J].中国心理卫生杂志,2015,29(10):733-737.
[11]陈大春,杨可冰,李艳丽,等.首发未用药精神分裂症认知功能及生活技能与临床特征的关系[J].中国神经精神疾病杂志,2015,41(1):26-31.
[12]Zhou Z,Zhu Y,Wang J,et al.Risperidone improves interpersonal perception and executive function in patients with schizophrenia[J].Neuropsychiatr Dis Treat,2016,12(13):101-107.
[13]Yasui-Furukori N,Kaneda A,Sugawara N,et al.Effect of adjunctive treatment with aripiprazole to atypical antipsychotics on cognitive function inschizophrenia patients[J].J Psychopharmacol,2013,26(6):806-812.
[14]Nielsen RE,Levander S,Kjaersdam Telléus G,et al.Second-generation antipsychotic effect on cognition in patients with schizophrenia—a meta-analysis of randomized clinical trials[J].Acta Psychiatr Scand,2015,131(3):185-196.
[15]储文革,陈燕,赵宜生,等.6种抗精神病药对精神分裂症首次发病患者认知功能影响的比较[J].临床精神医学杂志,2015,25(3):197-199.
[16]张敏桥,易鹏程,戴天刚.首发精神分裂症患者的治疗及社会功能改善研究[J].中国农村卫生事业管理,2014,34(6):709-711.