认知行为治疗对精神分裂症顽固性幻听的疗效研究

目的 探讨认知行为治疗对精神分裂症顽固性幻听的疗效.方法 60例伴有顽固性幻听的精神分裂症患者随机分为对照组和研究组,各30例.对照组接受常规治疗,研究组在常规治疗基础上联合认知行为治疗,即在8周的时间内给予8次认知行为治疗.采用阳性与阴性症状量表(PAN-SS)、精神病症状评定量表(PSYRATS)和焦虑自评量表(SAS)分别于治疗前、治疗结束时及随访24周评定患者的临床症状.结果 8周治疗结束时,在PANSS的一般精神病理和SAS评分上,研究组显著低于对照组(P＜0.05)；随访24周时,在PANSS的幻听、阳性症状、阴性症状、一般精神病理、PSYR-ATS和SAS评分上,研究组显著低于对照组(P＜0.05).对于幻听,研究组有效率显著高于对照组(P＜0.05).结论 认知行为治疗可能有助于改善精神分裂症的幻听症状,但需要进一步研究.

Effect of cognitive behavioral therapy on auditory hallucination of schizophrenia

Objective To evaluate the therapeutic effect of cognitive behavioral therapy （CBT） on auditory hallucination of schizophrenia. Methods Sixty schizophrertia patients with persistent auditory hallucination were randomly allocated to two groups： one received cognitive behavioral therapy and the other received standard treatment （ST）. The clinical outcomes were measured with Positive and Negative Syndrome （PANSS）, Psychotic Rating Scales （PSYRATS） and Self Rating Anxiety Scale （SAS）. These assessments were carried out at baseline, 8 weeks and 24 weeks post therapy. Results The scores of general symptom and SAS in CBT group were significantly lower than ST group at 8 weeks （P≤0.05）. The scores of hallucination, positive symptom, negative symptom, general symptom, PSYRATS and SAS in CBT group were significantly lower than ST group at 24 weeks. For auditory hallucination, the therapeutic effect of CBT was better than ST. Conclusions Cognitive behavioral therapy may improve schizophrenia＇s auditory hallucination, but further studies are needed.