药物自我治疗技能训练对慢性精神分裂症的效果

目的　探讨药物自我治疗技能训练 (SelfMedicationManagementSkillTraining)对慢性精神分裂症的效果。方法　将 6 8例服用氯氮平治疗的慢性精神分裂症患者随机分为药物自我治疗技能训练组 (简称训练组 )和对照组。训练组患者进行技能训练 ,共 12周。采用临床大体印象量表 (CGI)、简明精神病评定量表 (BPRS)和阴性症状评定量表 (SANS)进行效果评定 ,同时检测氯氮平和去甲氯氮平血浓度、外周血T细胞亚群与白介素Ⅱ受体 (SIL 2R)。结果　训练组患者阴性症状的改善以及免疫因子CD3 + 、CD4+ 和CD4+ /CD8+ 的增高均优于对照组 (P <0 0 5 ) ,且药物自我治疗技能显著提高 (P <0 0 1)。结论　药物自我治疗技能训练有助于慢性精神分裂症的治疗和康复     

银杏叶提取物对精神分裂症过氧化物歧化酶的作用

目的探讨银杏叶提取物（EGb）合并氟哌啶醇治疗对精神分裂症超氧化物歧化酶（SOD）的影响及其与临床疗效的关系。方法用固定剂量银杏叶提取物合并氟哌啶醇随机、双盲治疗82例患者12周，在治疗前后分别评定简明精神症状评定量表（BPRS）、阳性症状评定量表（SAPS）和阴性症状评定量表（SANS），并用双抗体放射免疫法测定SOD含量。结果（1）治疗前精神分裂症阳性症状与SOD值正相关（r=0．36，P＜0．01）；（2）EGb能提高抗精神病药的疗效，主要是治疗阳性症状的疗效；而且疗效与SOD值降低相关，表现为治疗前后SOD含量差值与BPRS、SAPS和SANS总分减分值分别呈正相关（r分别=0．38，0．45，0．29，P均＜0．01）；（3）治疗前患者SOD水平与疗效相关，表现为治疗前SOD值与BPRS、SAPS和SANS总分减分值分别呈正相关（r分别=0．37，0．42，0．34，P均＜0．01）。结论支持精神分裂症多巴胺功能亢进与阳性症状相关、并引起自由基生成增多的假说；银杏叶提取物提高抗精神病药疗效与其清除自由基、减轻过氧化损伤起作用相关。     

社区综合干预对精神分裂症患者社会康复效果的对照研究

目的观察社区综合干预措施对精神分裂症患者出院后社会康复的疗效。方法采取随机抽样法,将284例出院的精神分裂症患者随机分为干预组（143例）和对照组（141例）,对干预组进行健康教育、用药指导、技能训练、家庭治疗等综合干预,持续1年;对照组仅进行门诊随访。在入组时、半年末、一年末分别对两组患者采用社会功能缺陷筛选量表（SDSS）、阳性与阴性症状量表（PANSS）进行评估和比较。结果入组时干预组与对照组的SDSS、PANSS评分差异无显著性;干预1年后,干预组SDSS评分（7．54±2．11）明显低于对照组（9．77±2．74）,差异具有非常显著性（P〈0．01）。干预组PANSS评分（38．88±9．58）、阳性量表评分（7．40±1．12）、阴性量表评分（11．32±5．92）,一般精神病理量表评分（20．16±5．19）均低于对照组（46．884±16．37、8．60±3．19、13．52±7．81、24．76±8．08）,差异具有非常显著性（P〈0．01）。干预组复发率18．18％（26例）低于对照组34．75％（49例）,差异有非常显著性（χ^2=10．03,P〈0．01）。结论综合干预措施有利于出院后精神分裂症患者的社会康复。     

奎硫平与利培酮治疗精神分裂症的对照研究

目的验正奎硫平治疗精神分裂症的疗效及安全性。方法将121例精神分裂症患者随机分为奎硫平组（61例）与利培酮组（60例）,并进行对照研究,两药治疗剂量分别为200—800mg／d,2～5mg／d,疗程8周。采用阳性和阴性症状量表（PANSS）、简明精神病评定量表（BPRS）、治疗中出现的症状量表（TESS）进行评定及有关实验室检查。结果治疗结束时,两组PANSS和BPRS评分较入组时均显著减低（P〈0．01）,PANSS减分率奎硫平组为（65．7±28．1）,利培酮组为（66．4±27．3）,临床总有效率奎硫平组为70．5％,利培酮组为73．3％;两组疗效差异无显著性。奎硫平组的不良反应较利培酮组少,其中活动减少、震颤、扭转痉挛、静坐不能、口干、视物模糊、便秘、头晕的发生率显著少于利培酮组（P〈0．01或0．05）。结论国产奎硫平治疗精神分裂症的疗效与利培酮相当,部分不良反应较利培酮轻而少,是一种有效、耐受性较好的新型抗精神病药。     

药物自我处置和症状自我监控技能训练对预防精神分裂症复发的作用初探

目的探讨药物自我处置和症状自我监控技能训练对降低精神分裂症患者复发和提高其药物依从性的作用.方法将133例痊愈的精神分裂症患者随机分为技能训练组(以下简称训练组;66例)和对照组(67例).对训练组患者分组进行技能训练,共20周,两组均有64例完成1年随访.每月评定1次简明精神病量表(BPRS),每天以自制的监护人及患者药物依从性评分表进行评分;每2个月测定1次氯氮平血浓度.结果(1)入组时与随访末次评定差值的比较,训练组的BPRS总分[(3.3±13.7)分]、漏服药次数[(-0.9±3.0)次]、监护人药物依从性评分[(-53.0±31.2)分]和氯氮平血浓度[(85.5±44.8)ng/ml],均优于对照组,分别为[(-19.2±21.7)分]、[(-9.5±5.9)次]、[(26.5±24.3)分]和[(199.1±85.0)ng/ml],均P＜0.001;(2)训练组的复发率(12%)和再住院率(3%)低于对照组(分别为52%和38%;P＜0.001);(3)Kaplan-Meier生存分析显示,训练组的复发和再住院累计生存率优于对照组(复发的log-rankx2=25.62,再住院的log-rankx2=25.49,均P＜0.001).结论两种技能训练能降低精神分裂症患者的复发并提高其药物依从性.     

防风通圣散治疗精神分裂症104例临床研究

目的：探讨古方－防风通圣散对精神分裂症的临床疗效,副反应及其作用机理,方法：采用多中心开放随机对照研究,对104例精神分裂症患者用常规抗精神病药加服防风通圣散煎剂结合治疗,与126例单用常规抗精神药治疗的精神分裂症患者对照。以简明精神病评定量表（BPRS）和阳性症状评定量表（SAPS）,阴性症状评定量表（SANS）,临床疗铲总评量表（CGI）和副反应量表（TESS）,锥体外系副反应量表（RSESE）^[1]综合评定。结果：治疗后防风通圣散组（治疗组）患者的CGI－SI与CGI－GI分值和BPRS,SAPS,SANS量表的总分及因子分均低于单用常规抗精神病药治疗组（对照组）患者,差异均有显著性（P＜0．01）,TES总分与RSESE总分在整个治疗过程中均低于对照组,差异有显著性（P＜0．01）,结论：治疗组对精神分裂症的疗效较好;对阳性,阴性症状的改善明显优于对照组,副反应显著较少,安全度较好,调畅各脏腑机能与气机的运动形式,内通外达是其作用的机理。     

自我管理综合技能训练对精神分裂症患者康复及幸福感与自尊的影响

目的：观察自我管理综合技能训练对精神分裂症患者康复疗效及幸福感与自尊的影响。方法选取2012‐02—2013‐04我科治疗的精神分裂症患者112例为研究对象,采用随机数表法分成观察组、对照组。对照组行精神科常规护理,观察组在对照组基础上行自我管理综合技能训练。采用住院患者观察量表（NOSIE）、简明精神病评定量表（BPRS）、总体幸福感量表（GWB）及自尊量表（SES）于治疗前与治疗3个月后对患者进行评价。结果观察组治疗后社会能力、个人卫生、社会兴趣等积极方面评分明显高于对照组,差异有统计学意义（P＜0.05）;观察组治疗后抑郁、退缩、激惹等消极方面评分明显低于对照组,差异有统计学意义（P＜0.05）;观察组治疗后精神症状评分低于对照组,但差异无统计学意义（P＞0.05）。观察组BPRS干预后评分明显低于对照组,差异有统计学意义（P＜0.05）;观察组GWB、SES干预后评分明显高于对照组,差异有统计学意义（P＜0.05）。结论自我管理综合技能训练可明显提高精神分裂症患者的幸福感和自尊,是一种有效的治疗方式。     

护理管理模式对精神分裂症患者社会功能的影响

目的探讨不同护理管理模式对住院精神分裂症患者社会功能的影响。方法对符合ICD-10诊断标准的首发精神分裂症患者,经家庭式开放式的病房管理60例、封闭式病房管理60例治疗,于入院时、治疗2周末、4周末、6周末用简明精神病评定量表（BPRS）、住院精神病患者社会功能评定量表（SSPI）,评价其精神症状严重程度及社会功能情况。结果家庭式开放式管理模式组明显提高了患者的社会功能,SSPI减分明显,研究组明显高于对照组（P〈0．01）,而治疗后BPRS总分比较差异无显著意义（P〉0．05）。结论开放式管理有利于提高首发精神分裂症患者适应社会技能。     

家庭干预联合药物自我管理技能训练治疗精神分裂症的疗效

目的 探讨家庭干预联合药物自我管理技能训练治疗精神分裂症的效果.方法 160例精神分裂症患者随机分为观察组和对照组各80例,对照组接受常规治疗,观察组在此基础上给予家庭干预联合药物自我管理技能训练,观察2组简明精神病量表(BPRS)、社会功能缺陷筛选量表(SDSS)、生存质量测量量表(BREF)、阳性症状评定量表(SAPS)和阴性症状评定量表(SANS)评分.结果 2组治疗前各项评分差异均无统计学意义(P＞0.05),治疗6个月与治疗前比较,均明显下降,差异有统计学意义(P＜0.05);观察组优于对照组,差异有统计学意义(P＜0.05).结论 家庭干预联合药物自我管理技能训练提高了治疗依从性,改善了病情、社会功能及生活质量,精神分裂症阳性和阴性症状也明显降低.     

易肇事精神分裂症患者应用程式化技能训练的疗效研究

目的 探讨程式化技能训练对易肇事精神分裂症患者的疗效.方法 将102例易肇事精神分裂症患者随机分为训练组(51例)和对照组(51例).两组患者接受常规药物及康复治疗的同时,仅对训练组进行8周的程式化技能训练.训练结束后对两组均进行半年的随访,并采用阳性和阴性症状量表(PANSS)在入组时、训练结束时、随访第3,6个月时进行评估.结果 与入组时相比,训练组患者训练结束时的PANSS总分、阳性量表分、阴性量表分均显著降低(P＜0.05).训练结束后及随访期,训练组患者的PANSS部分项目评分显著低于对照组患者(P＜0.05).结论 程式化技能训练对易肇事精神分裂症患者的精神症状具有康复作用.     

Technique for training schizophrenic patients in illness self-management: a controlled trial.

OBJECTIVE: To determine whether schizophrenic outpatients receiving low-dose neuroleptic therapy could learn and retain complex information and skills related to self-management of their illness, a novel technique of teaching, using cognitive and behavioral methods, was designed to compensate for the patients' learning disabilities. METHOD: The subjects were 41 patients with DSM-III-R schizophrenia who were receiving constant maintenance neuroleptic drug therapy. They were randomly assigned to structured, modularized skills training or to supportive group psychotherapy. RESULTS: The patients who received skills training made significant gains in each of the areas taught, while those participating in group therapy did not. The skills learned during training were retained without significant erosion over a 1-year follow-up period. CONCLUSIONS: The effectiveness of modularized teaching of illness self-management skills to schizophrenic patients appears to be largely independent of baseline psychology and symptom improvement. Such an approach is useful for overcoming or compensating for the enduring cognitive and information processing deficits commonly found in schizophrenia.     

Neuropsychological deficits in 'primary' and 'secondary' non-medical drug users.

An extensive neuropsychological test battery, specifically designed to investigate brain-behaviour relationships, was administered to two groups of multiple drug users. The 'primary' group consisted of subjects referred fundamentally on account of drug abuse problems. The 'secondary' group were referred principally for neurological reasons, but during history taking they reported drug use. Fifty patients, in all, were examined. Results showed that people who have received psychiatric care for drug abuse and who had started using drugs at an earlier age ('primary' group) had fewer adaptive resources and limited psychometric and academic achievement skills. This effect cannont be attributed to personality differences. Both groups had noticeably greater difficulties on motor tests, fine manipulative skills, and Halstead's Impairment Index when compared with a normal control group matched for age and sex.     

The simultaneous replication design: The use of a multiple baseline to establish experimental control in single group social skills treatment studies

Behavior therapists, especially those in service-oriented applied settings, are often confronted with the need to conduct social skills or assertive training in groups. While single subject multiple baseline analyses have been widely used in the research literature, there are few well-controlled group treatment evaluation design choices feasible for the behavioral clinician without ready access to large numbers of control subjects. The present paper describes a group multiple baseline-simultaneous replications treatment design which establishes experimental control within a single ongoing training group by combining group treatment with behavioral assessment of each subject following each group session. This extension of multiple baseline analysis techniques to group social skills training can prove useful for more rigorously evaluating the effectiveness of social skills interventions in many applied settings.     

The ability of modifying cognitive deficits in the area of social functioning in chronic schizophrenic patients

The paper concerns the effectiveness of rehabilitation of chronically ill schizophrenic patients who participate in social skills training. The assumption was that the participation in a four-month training programme (as authored by R. P. Liberman) will improve emotional problem solving, ability to keep in norms and conflict solving as well as the ability of cause-effect thinking. 100 schizophrenic patients and their families participated in the study. Half of those studied participated in the social skills training programme and the half who did not, were the control group. The subjects were examined twice in the four months. The following tools were used: "Means Ends Problem Solving" by Platt and Spivack, "PANSS" by Kay and Fiszbein, "Social-demographic questionnaire". Before the study period the groups did not vary much in the aspect of interpersonal social skills solving. After the training, the participants benefited significantly in the effectiveness of their problem solving and other criteria improved as well. It was concluded that the study of a group of 100 chronic schizophrenic patients who participated in a four month social skills training programme has a significant effect on social skills problem solving. The improvement of those skills consisted of: interpersonal and emotional problem solving, prediction of the consequences of one's actions, cause-effect thinking and alternative thinking.     

Work-related social skills training for people with schizophrenia in Hong Kong

This article describes a prospective blinded outcome study of a vocational social skills training program developed in Hong Kong for people affected by chronic schizophrenia. The aim was to improve their ability to find and keep a job. Participants were randomly assigned to three groups: a social skills training group with followup support, a social skills training group without followup support, and a comparison group who received standard after-care treatment. Participants who had participated in either of the training groups statistically outperformed those in the comparison group. Those receiving the training plus followup were statistically much more successful at finding and keeping a job than participants in either of the other two groups. A comparatively small amount of followup contact (a monthly group meeting or phone call) for 3 months after the training finished had a very significant effect on participants' success rate.     

Development of self-care skills and helping behaviors of adolescents in a group home through correspondence training

The present study used a do-report correspondence training procedure to develop self-care skills and helping behaviors among adolescents of a group home. Points were delivered contingent upon true reports about behaviors (self-care skills and helping behaviors) performed earlier. Two multiple-baseline designs (across behaviors and across groups) were employed. The results showed increased levels of self-care skills and helping behaviors (the corresponding nonverbal behaviors) during reinforcement of true reports, relative to baseline conditions. These levels were maintained during the introduction of a follow-up (maintenance) phase, in which subjects were exposed to similar procedures of correspondence training but with no reinforcement contingencies for truthful reports about prior behaviors.     

抑郁症康复技能训练程式对预防抑郁症复发和自杀的作用

目的探讨抑郁症康复技能训练程式对预防抑郁症复发和自杀的作用。方法将80例抑郁症患者随机分为康复技能训练组(干预组,40例)和健康教育组(对照组,40例)。对干预组和对照组分别应用抑郁症康复技能训练程式和健康教育方法进行干预4周,分别于基线、3个月、6个月、9个月和12个月随访两组抑郁症复发、住院、自杀求助和自杀死亡情况,并采用世界卫生组织生存质量测定量表简表评估生存质量。结果干预后12个月,干预组复发率(10.0%vs.42.5%)和住院率(5.0%vs.20.0%)均低于对照组,差异均有统计学意义(P0.05)。干预组自杀求助率高于对照组(25.5%vs.7.5%),差异有统计学意义(P0.05);两组自杀死亡率(0%vs.2.5%)差异无统计学意义(P0.05)。干预组生存质量总分在各随访时点均高于对照组,差异均有统计学意义(P0.05)。结论抑郁症康复技能训练程式能有效预防抑郁症患者复发和降低其自杀风险,并提高患者生存质量,具有推广应用价值。     

Group therapy for adolescent depressive disorder: a comparison of social skills and therapeutic support

Two forms of short-term group therapy for depressed adolescents are compared. Adolescents were assigned to either a social skills training or therapeutic support group. Treatment outcome was based on self-report and semistructured clinical interviews for depression, measures of self-concept, and cognitive distortions. After treatment, adolescents in the therapeutic support groups showed significantly greater reductions in clinical depression and significant increases in self-concept compared with those in the social skills training group. These group differences were no longer evident at 9-month follow-up, as adolescents in the therapeutic support groups maintained their improvement, and adolescents in the social skills training groups caught up.     

Numerical skills in children with Down syndrome. Can they be improved?

The present study aims to explore the impact of a numerical skills training program on the basic mathematical skills and logical thinking in children with Down syndrome (DS). The training program was built specifically for children with DS, bearing the strengths and weaknesses of their particular cognitive profile in mind. Two groups of children with DS took part in the study. All children were tested before and after the training on measures of numerical skills and logical thinking. One group of 27 children was trained in numerical skills twice a week for 2 months, for about 30 min per session. A control group of 9 children was not involved in any training session. After training, children in the intervention group performed better in numerical tests, while those in the control group did not. These results suggest that our training program is both feasible and effective for children with Down syndrome.     

Development of specific social skills training programmes for schizophrenia patients: results of a multicentre study

OBJECTIVE: The efficacy of three newly developed cognitive social skills training programmes for residential, vocational and recreational functioning (experimental groups) were compared with a traditional social skills training programme (control group) referring to cognitive and social abilities, psychopathology and generalisation effects. METHOD: One hundred and five patients with a diagnosis of schizophrenia or schizoaffective disorder according to ICD-10 criteria were selected and assigned to the different treatment groups, using a matching procedure. The treatment phase lasted 6 months. A follow-up assessment was carried out after 1 year. RESULTS: Higher global therapy effects were obtained on almost all dependent variables in the experimental groups. Analyses of variance and covariance indicated higher symptom reduction for the experimental groups, but significantly greater improvements in some cognitive variables for the control group. Correlation analysis suggested associations between improvement of social behaviour with symptom reduction and improvements of cognitive skills. CONCLUSION: In view of these favourable effects, the developed cognitive social skills training programmes might facilitate the abilities of schizophrenia patients for their integration in the community.