认知行为治疗对女性首发偏执型精神分裂症的早期疗效观察

目的:观察认知行为治疗(CBT)对首发偏执型精神分裂症的早期疗效和预后观察。方法:选取首发偏执型精神分裂症患者60例,随机分为研究组和对照组,研究组(CBT合并奥氮平组)和对照组(奥氮平组)各30例,研究组在口服奥氮平基础上,进行为期12周的CBT治疗,随访6个月。采用阳性与阴性症状量表(PANSS)评价疗效,社会功能缺陷量表(SDSS)评定社会功能,副反应量表(TESS)评定不良反应。结果:治疗12周末及随访结束时,研究组与对照组同期对比,PANSS各项评分显著降低(P<0.05或P<0.01)。半年随访时,研究组SDSS大部分项目评分显著低于对照组(P<0.01);研究组与对照组复发率分别为23.3%和51.7%,研究组与对照组停药率分别为6.7%和31.0%,均有显著性差异(P<0.05)。结论:CBT合用奥氮平治疗首发偏执型精神分裂症,比单一药物治疗更具有优越性,近期疗效更明显,治疗依从性更好,复发率明显降低。

Observation of early curative effect of cognitive behavior therapy combined with olanzapine on female first-episode paranoid schizophrenia

Objective：To observe early curative effects and prognosis of cognitive behavior therapy （ CBT ） on first-episode paranoid schizophrenia. Methods：60 cases of first episode paranoid schizophrenia were randomly divided into study group （30 cases, CBT combined with olanzapine group） and control group （30 cases, olanzapine group）. The cases in study group were treated by CBT combined with olanzapine for 12 weeks whereas those in control group were only treated by olanzapine, and they were all followed up for 6 months. Positive and negative symptoms scale （ PANSS） was used to assess the efficacy, social function defect scale （ SDSS） was used to evaluate the social function, and treatment emergent symptom scale （ TESS） was used to assess the adverse reactions. Results：12 weeks after the treatment and at the end of the follow-up, the PANSS scores of study group and control group in the same period de-creased significantly （P〈0. 05 or P〈0. 01）. When the six-month follow-up was performed, the SDSS score of study group was signifi-cantly lower than that of control group （P〈0. 01）. The recurrence rate of study group and control group were 23. 3% and 51. 7%, the drug-withdrawal rates of study group and control group were 6. 7% and 31. 0%, and there were both significant differences （ P〈0. 05 ） . Conclusions：CBT combined with olanzapine in the treatment of first episode paranoid schizophrenia has more advantages than the single drug, treatment, and has more obvious short-term effects, better treatment compliance, and lower recurrence rate.