康复期精神病患者认知心理治疗的远期效果对比观察

目的探讨康复期精神病患者认知心理治疗的远期效果。方法对康复期精神病患者随机分为干预组81例,对照组75例,进行为期12年的对比观察。对照组仅进行一般的精神卫生知识宣教,干预组则在综合干预的基础上,重点进行认知心理治疗,步骤是:①使患者了解自己不合理信念或看法,以及不合理信念与不良情绪和行为的关系;②让患者明确自己对不良情绪和行为等结果负有责任,促使其积极参与治疗过程;③帮助患者改变或者放弃不合理信念:④学习合理观念及接受理性的生活哲学,减少或者避免不良信念的影响。结果干预后各个时点PANSS、SDSS减分率干预组快于对照组(P<0.01),复发率低于对照组(P<0.01);再就业率干预组高于对照组(χ2=11.97,P<0.01),再住院率及住院费用对照组却高于干预组(χ2=8.63、10.15,P<0.01)。结论以认知心理治疗为主的综合干预措施,可有效调动患者的主观能动作用,使治疗效果持久。

Long-term Effect of Cognitive Psychotherapy on Patients with Psychosis during Convalescence

Objective To investigate the long-term effect of cognitive psychotherapy on patients with psychosis during convalescence.Methods Patients with psychosis during convalescence were randomly divided into intervention group(81 cases)and control group(75 cases) for a period of 12 years of comparative study.The control group only for general mental health knowledge of missionary,while intervention group received cognitive psychotherapy on the basis of the comprehensive intervention,the steps included.①Made patients understand their own irrational belief or opinion,and the relationship between irrational beliefs,negative emotions and behavior.②Enable patients to clear their negative emotions and behavior of the results of responsibility to promote their active participation in the treatment process.③To help patients change or give up the irrational belief:④Learned to accept a reasonable and rational concept of philosophy of life,reduce or avoid the adverse effects of irrational belief.Results After the intervention each time,PANSS,SDSS scores of intervention group reduced faster than those of control group(P<0.01),relapse rate was lower than the control group(P<0.01);reemployment rate was 5 times higher in the intervention group(χ2=11.97,P<0.01),readmission rates and hospital costs of the control group was 3 times higher than the intervention significantly(χ2=8.63,10.15,P<0.01).Conclusion Integrated intervention measures based cognitive therapy can effectively mobilize the patient’s subjective dynamic role,and has a lasting efficacy.