心理社会干预对康复期精神分裂症病情影响的对照研究

目的探讨心理社会干预配合药物治疗对康复期精神分裂症患者精神症状的影响。方法对120名康复期精神分裂症患者进行病例配对对照的前瞻性研究。试验组60人,服用抗精神病药配合心理社会干预。对照组仅单纯服用抗精神病药物治疗。两组分别在入组时、治疗3个月、6个月、9个月以及12个月时进行大体评定量表、Montgomery-Asberg抑郁量表、阳性症状和阴性症状评定量表、自知力与治疗态度问卷进行评定。结果治疗3个月时,试验组在阳性症状和阴性症状评定量表中的一般精神病理分量表（P=0.039）及思维障碍因子（P=0.043）得分低于对照组,差异有统计学意义。6个月时,试验组在一般精神病理分量表（P=0.03）及反应缺乏因子（P=0.018）的得分低于对照组,差异有统计学意义。9个月时,试验组除了阳性量表和思维障碍因子外,其余各项得分均低于对照组,差异有统计学意义。12个月时,试验组各项得分均低于对照组,差异有统计学意义。结论心理社会干预能更好地改善康复期精神分裂症患者各方面的精神病症状、改善抑郁情绪、提高自知力同时改善大体功能水平。

The influence of psychosocial intervention on psychosis symptoms of schizophrenia after acute episode

Objective To explore the influence of antipsychotics plus psychosocial intervention on psychosis symptoms of schizophrenia after acute episode. Methods A total of 120 patients were assigned by paired design to either study group with antipsychotics plus psychosocial intervention （n=60） or control group with antipsy- chotics only （n=60）. The Positive and Negative Symptoms Scale （PANSS）, Global Assessment Scale（GAS） , Montgomery-Asberg Depression Scale（MADRS）, Insight and Treatment Attitude Questionnaire（ITAQ）were assessed at baseline, 3-month,6-month ,9-month and 12-month after treatment. Results At 3-month follow- up significant reductions were observed for scores of PANSS-geheral scale（P=0. 039）, PANSS-thought disorder （P=0. 043）in study group than those in control group. At 6-month follow-up, significant reductions were observed for scores of PANSS-general scale （P= 0.03）, PANSS-response falttening（P = 0. 018） for in study group than in control group. At 9-month follow-up all factor scores of the scales but PANSS positive scale and thought disorder in study group than those in control group were significantly lower. At 12-month follow-up all factor scores were significantly lower in study group than those in control group. Conclusion Psychosocial intervention could improve psychosis symptoms, depression symptoms , global functions and the insight to disease in patients with schizophrenia after acute episode.