认知行为干预对首发精神分裂症远期疗效的对照研究

目的 :探讨认知行为干预 (心理治疗 )对首发精神分裂症患者疗效的影响。方法 :对 1998年6月以来 2 5 1例首次住院治疗的精神分裂症患者 ,于治疗的第三个阶段随机分为抗精神病药物合并心理治疗组 (研究组 ,12 6例 )及单用抗精神病药物组 (对照组 ,12 5例 ) ,两组均采用同样的药物维持治疗。研究组服氯氮平 (12 7 5± 73 1)mg/d (4 5例 ) ,利培酮 (2 4± 1 4)mg/d (81例 ) ;对照组服氯氮平 (12 3 2± 77 3 )mg/d (4 7例 ) ,利培酮 (2 3± 1 6)mg/d (78例 )。经 2年的随访观察 ,分别对两组的复发率 ,自知力评分 ,服药依从性 ,和阴阳性症状评定量表 (PANSS)总分进行比较。结果 :研究组复发率低于对照组 (P <0 0 1) ;研究组的自知力好于对照组 (P <0 0 1) ;研究组的PANSS总分及因子分均低于对照组 (P <0 0 1～ 0 0 5 )。结论 :对首发精神分裂症患者进行认知行为干预 ,可提高患者的疗效及服药依从性 ,减少疾病的复发率。

Controlled Study on Long-term Effect of Cognitive Behavior Intervention on First Episode Schizophrenia

Objective: To study the long term effect of cognitive behavior intervention on first episode schizophrenia Method:251 first episode schizophrenics were randomly divided into intervention group (receiving cognitive behavior intervention and regular antipsychotics, n=126) and control group (receiving regular antipsychotics only, n=125) There was no significant difference of antipsychotics used between the two groups Both groups were followed for 2 years, using PANSS (positive and negative symptom scale) to assess the severity of symptoms The rate of relapse, compliance with treatment and insight to illness were also recorded Result:The intervention group had lower rates of relapse (1 6% at half-year in follow up, 7 1% at the end of 2 years follow up) than control (12 8% and 23 2% respectively) The total score and factor scores of PANSS were lower in intervention groups Patients in intervention groups had also better insight to illness and better compliance to treatment Conclusion:The cognitive behavior intervention is benefit patients with first episode schizophrenia