元认知训练对精神分裂症疗效及社会认知功能的研究
发布时间：2019-06-27 11:09
【摘要】：背景精神分裂症是一种病因尚未确定、慢性迁延性的重性精神疾病,世界上约0.5%-1%的人口深受其苦。近年有研究发现,即使临床广泛应用了非典型抗精神病药,但仍有部分患者由于不能坚持抗精神病药物的全病程治疗,从而导致了疾病的反复发作。有研究表明,心理治疗能够在药物治疗的基础上增加一个小到中等大小的效应,为精神疾病患者提供了一个可行的治疗方法。元认知训练计划(Metacognitive Training program,MCT)是在改善精神分裂症患者妄想信念的前提下,提高患者对精神病性症状的认识,从而改善患者的临床康复及预后。因此,通过对元认知训练计划的进一步研究,则将会为精神分裂症患者症状的改善及整体预后提供一种新的理论依据及技术支持。目的1.探讨元认知训练联合奥氮平对精神分裂症患者的临床症状、自知力及药物依从性的影响。2.探讨元认知训练联合奥氮平对精神分裂症患者的认知自知力、社会认知功能障碍的影响。方法1.采用病例对照研究方法,依据疾病和有关健康问题的国际统计分类第十版(ICD-10)精神分裂症的诊断标准收集精神分裂症患者107例,随机将患者分配到元认知训练治疗组(即研究组,n=54)和奥氮平治疗组(即对照组,n=53),研究组患者给予奥氮平片合并元认知训练,对照组患者给予奥氮平片治疗并给予支持性心理治疗,疗程均为4周。2.对所有受试者进行一般资料收集,并在基线和治疗后进行阳性与阴性症状量表(Positive and Negative Syndrome Scale,PANSS),自知力与治疗态度问卷(Insight and Treatment Attitude Questionnaire,ITAQ),服药依从性量表(Medication Adherence Rating Scale,MARS),贝克认知自知力量表(The Beck Cognitive Insight Scale,BCIS),内在、他人及环境归因问卷(Internal,Personal and Situational Attributions Questionnaire,IPSAQ),失言觉察任务量表(Faux Pas Recognition Task,FPRT)的评定。3.所有数据应用SPSS19.0统计软件进行统计分析。计量资料采用独立样本t检验、配对t检验。双侧P0.05为差异具有统计学意义。结果以均数±标准差(x±s)表示。结果1.治疗4周末,研究组和对照组与其各基线相比,PANSS总分及各分量表和IPSAQ评分均低于对照组,差异有统计学意义(P0.05);MARS评分、ITAQ、BCIS及FPRT评分均高于对照组,其差异有统计学意义(P0.05)。2.基线时研究组和对照组各量表评分差异无统计学意义(P0.05)。治疗4周末研究组PANSS总分及各分量表分、IPSAQ评分均显著低于对照组,差异有统计学意义(P0.05);研究组MARS评分、ITAQ评分、BCIS及FPRT评分显著高于对照组,其差异有统计学意义(P0.05)。3.治疗4周末,对照组PANSS总分及各因子分、IPSAQ评分与基线之间的差值均显著低于研究组,差异有统计学意义(P0.05)。研究组MARS、ITAQ、BCIS及FPRT评分与基线之间的差值均显著高于对照组,其差异有统计学意义(P0.05)。结论1.元认知训练作为药物治疗的辅助性治疗手段,能够改善精神分裂症患者的临床症状及治疗依从性。2.元认知训练作为药物治疗的辅助性治疗手段,能够改善与精神分裂症患者预后相关的自知力、认知自知力及社会认知功能。
[Abstract]:Background Schizophrenia is a cause of disease that has not yet been established, with a major mental disorder of chronic persistent nature, and about 0.5% to 1 per cent of the world's population is suffering. In recent years, it has been found that even though the clinical application of atypical antipsychotics has been widely used, some patients have been unable to adhere to the full course of treatment of antipsychotic drugs, thus leading to the repeated onset of the disease. Studies have shown that psychotherapy can increase a small to medium-sized effect on the basis of drug therapy, providing a viable treatment for psychiatric patients. Metacognitive training program (MCT) is a kind of cognitive training program (MCT), which can improve the patient's understanding of psychotic symptoms and improve the patient's clinical recovery and prognosis. Therefore, through the further study of the metacognitive training program, it will provide a new theoretical basis and technical support for the improvement of the symptoms and overall prognosis of the patients with schizophrenia. Objective 1. To study the effect of combination of metacognitive training and olanzapine on the clinical symptoms, self-knowledge and drug compliance in patients with schizophrenia. To study the effect of the combination of metacognitive training and olanzapine on the cognitive self-knowledge and the social cognitive function in the patients with schizophrenia. Method 1. A case-controlled study was used to collect 107 patients with schizophrenia in accordance with the diagnostic criteria for schizophrenia in the tenth edition (ICD-10) of the International Statistical Classification of Diseases and Related Health (ICD-10), and randomly assigned the patient to the metacognitive training treatment group (i.e., the study group, N = 54) and olanzapine in the treatment group (i.e., the control group, n = 53), and the study group treated with the olanzapine plain film and the metacognitive training, the control group treated with the olanzapine plain film and given supportive psychotherapy, the course of treatment was 4 weeks. The general data collection was performed on all subjects and positive and negative symptoms scale (PANSS), self-knowledge and treatment attitude questionnaire (ITAQ), and medication compliance scale (MARS) were performed after baseline and treatment. The Beck Cognitive Insight Scale (BCIS), the internal, the personal and the environment attribution questionnaire (IPSAQ), the loss-of-speech awareness task (FPRT) assessment. All data was statistically analyzed using the SPSS19.0 statistical software. The measurement data is tested by independent sample t and paired t. The difference of the two-sided P0.05 was of statistical significance. The results were expressed in the mean square standard deviation (x% s). Results 1. Compared with the control group, the total score of PANSS and the scores of each component and IPSAQ were lower than that of the control group at the end of the 4-week treatment group (P0.05). The score of MARS, ITAQ, BCIS and FPRT was higher than that of the control group, and the difference was significant (P0.05). There was no significant difference in the scale scores between the study group and the control group at baseline (P0.05). The scores of PANSS and scores of scores and IPSAQ in the study group were significantly lower than that in the control group (P <0.05). The score of MARS, ITAQ, BCIS and FPRT in the study group was significantly higher than that in the control group (P0.05). The total score of PANSS in the control group and the score of each factor in the control group were significantly lower than that of the study group at the end of the treatment for 4 weeks, and the difference was statistically significant (P0.05). The difference of MARS, ITAQ, BCIS and FPRT between the study group and the baseline was significantly higher than that in the control group (P0.05). Conclusion 1. Metacognitive training can improve the clinical symptoms and treatment compliance of the patients with schizophrenia. Metacognitive training, as an auxiliary treatment for drug therapy, can improve the self-knowledge, the cognitive self-knowledge and the social cognitive function related to the prognosis of the patients with schizophrenia.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.3
本文编号：2506734
[Abstract]:Background Schizophrenia is a cause of disease that has not yet been established, with a major mental disorder of chronic persistent nature, and about 0.5% to 1 per cent of the world's population is suffering. In recent years, it has been found that even though the clinical application of atypical antipsychotics has been widely used, some patients have been unable to adhere to the full course of treatment of antipsychotic drugs, thus leading to the repeated onset of the disease. Studies have shown that psychotherapy can increase a small to medium-sized effect on the basis of drug therapy, providing a viable treatment for psychiatric patients. Metacognitive training program (MCT) is a kind of cognitive training program (MCT), which can improve the patient's understanding of psychotic symptoms and improve the patient's clinical recovery and prognosis. Therefore, through the further study of the metacognitive training program, it will provide a new theoretical basis and technical support for the improvement of the symptoms and overall prognosis of the patients with schizophrenia. Objective 1. To study the effect of combination of metacognitive training and olanzapine on the clinical symptoms, self-knowledge and drug compliance in patients with schizophrenia. To study the effect of the combination of metacognitive training and olanzapine on the cognitive self-knowledge and the social cognitive function in the patients with schizophrenia. Method 1. A case-controlled study was used to collect 107 patients with schizophrenia in accordance with the diagnostic criteria for schizophrenia in the tenth edition (ICD-10) of the International Statistical Classification of Diseases and Related Health (ICD-10), and randomly assigned the patient to the metacognitive training treatment group (i.e., the study group, N = 54) and olanzapine in the treatment group (i.e., the control group, n = 53), and the study group treated with the olanzapine plain film and the metacognitive training, the control group treated with the olanzapine plain film and given supportive psychotherapy, the course of treatment was 4 weeks. The general data collection was performed on all subjects and positive and negative symptoms scale (PANSS), self-knowledge and treatment attitude questionnaire (ITAQ), and medication compliance scale (MARS) were performed after baseline and treatment. The Beck Cognitive Insight Scale (BCIS), the internal, the personal and the environment attribution questionnaire (IPSAQ), the loss-of-speech awareness task (FPRT) assessment. All data was statistically analyzed using the SPSS19.0 statistical software. The measurement data is tested by independent sample t and paired t. The difference of the two-sided P0.05 was of statistical significance. The results were expressed in the mean square standard deviation (x% s). Results 1. Compared with the control group, the total score of PANSS and the scores of each component and IPSAQ were lower than that of the control group at the end of the 4-week treatment group (P0.05). The score of MARS, ITAQ, BCIS and FPRT was higher than that of the control group, and the difference was significant (P0.05). There was no significant difference in the scale scores between the study group and the control group at baseline (P0.05). The scores of PANSS and scores of scores and IPSAQ in the study group were significantly lower than that in the control group (P <0.05). The score of MARS, ITAQ, BCIS and FPRT in the study group was significantly higher than that in the control group (P0.05). The total score of PANSS in the control group and the score of each factor in the control group were significantly lower than that of the study group at the end of the treatment for 4 weeks, and the difference was statistically significant (P0.05). The difference of MARS, ITAQ, BCIS and FPRT between the study group and the baseline was significantly higher than that in the control group (P0.05). Conclusion 1. Metacognitive training can improve the clinical symptoms and treatment compliance of the patients with schizophrenia. Metacognitive training, as an auxiliary treatment for drug therapy, can improve the self-knowledge, the cognitive self-knowledge and the social cognitive function related to the prognosis of the patients with schizophrenia.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.3
【参考文献】
相关硕士学位论文 前1条
1 田琪;内在，，他人及环境归因问卷的中文版修订及与脑r-fMRI信号的相关研究[D];浙江大学;2012年
本文编号：2506734
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