元認(rèn)知訓(xùn)練對精神分裂癥療效及社會(huì)認(rèn)知功能的研究
發(fā)布時(shí)間：2019-06-27 11:09
【摘要】：背景精神分裂癥是一種病因尚未確定、慢性遷延性的重性精神疾病,世界上約0.5%-1%的人口深受其苦。近年有研究發(fā)現(xiàn),即使臨床廣泛應(yīng)用了非典型抗精神病藥,但仍有部分患者由于不能堅(jiān)持抗精神病藥物的全病程治療,從而導(dǎo)致了疾病的反復(fù)發(fā)作。有研究表明,心理治療能夠在藥物治療的基礎(chǔ)上增加一個(gè)小到中等大小的效應(yīng),為精神疾病患者提供了一個(gè)可行的治療方法。元認(rèn)知訓(xùn)練計(jì)劃(Metacognitive Training program,MCT)是在改善精神分裂癥患者妄想信念的前提下,提高患者對精神病性癥狀的認(rèn)識,從而改善患者的臨床康復(fù)及預(yù)后。因此,通過對元認(rèn)知訓(xùn)練計(jì)劃的進(jìn)一步研究,則將會(huì)為精神分裂癥患者癥狀的改善及整體預(yù)后提供一種新的理論依據(jù)及技術(shù)支持。目的1.探討元認(rèn)知訓(xùn)練聯(lián)合奧氮平對精神分裂癥患者的臨床癥狀、自知力及藥物依從性的影響。2.探討元認(rèn)知訓(xùn)練聯(lián)合奧氮平對精神分裂癥患者的認(rèn)知自知力、社會(huì)認(rèn)知功能障礙的影響。方法1.采用病例對照研究方法,依據(jù)疾病和有關(guān)健康問題的國際統(tǒng)計(jì)分類第十版(ICD-10)精神分裂癥的診斷標(biāo)準(zhǔn)收集精神分裂癥患者107例,隨機(jī)將患者分配到元認(rèn)知訓(xùn)練治療組(即研究組,n=54)和奧氮平治療組(即對照組,n=53),研究組患者給予奧氮平片合并元認(rèn)知訓(xùn)練,對照組患者給予奧氮平片治療并給予支持性心理治療,療程均為4周。2.對所有受試者進(jìn)行一般資料收集,并在基線和治療后進(jìn)行陽性與陰性癥狀量表(Positive and Negative Syndrome Scale,PANSS),自知力與治療態(tài)度問卷(Insight and Treatment Attitude Questionnaire,ITAQ),服藥依從性量表(Medication Adherence Rating Scale,MARS),貝克認(rèn)知自知力量表(The Beck Cognitive Insight Scale,BCIS),內(nèi)在、他人及環(huán)境歸因問卷(Internal,Personal and Situational Attributions Questionnaire,IPSAQ),失言覺察任務(wù)量表(Faux Pas Recognition Task,FPRT)的評定。3.所有數(shù)據(jù)應(yīng)用SPSS19.0統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)分析。計(jì)量資料采用獨(dú)立樣本t檢驗(yàn)、配對t檢驗(yàn)。雙側(cè)P0.05為差異具有統(tǒng)計(jì)學(xué)意義。結(jié)果以均數(shù)±標(biāo)準(zhǔn)差(x±s)表示。結(jié)果1.治療4周末,研究組和對照組與其各基線相比,PANSS總分及各分量表和IPSAQ評分均低于對照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);MARS評分、ITAQ、BCIS及FPRT評分均高于對照組,其差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2.基線時(shí)研究組和對照組各量表評分差異無統(tǒng)計(jì)學(xué)意義(P0.05)。治療4周末研究組PANSS總分及各分量表分、IPSAQ評分均顯著低于對照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);研究組MARS評分、ITAQ評分、BCIS及FPRT評分顯著高于對照組,其差異有統(tǒng)計(jì)學(xué)意義(P0.05)。3.治療4周末,對照組PANSS總分及各因子分、IPSAQ評分與基線之間的差值均顯著低于研究組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。研究組MARS、ITAQ、BCIS及FPRT評分與基線之間的差值均顯著高于對照組,其差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論1.元認(rèn)知訓(xùn)練作為藥物治療的輔助性治療手段,能夠改善精神分裂癥患者的臨床癥狀及治療依從性。2.元認(rèn)知訓(xùn)練作為藥物治療的輔助性治療手段,能夠改善與精神分裂癥患者預(yù)后相關(guān)的自知力、認(rèn)知自知力及社會(huì)認(rèn)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.
【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R749.3
本文編號：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.
【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R749.3
【參考文獻(xiàn)】
相關(guān)碩士學(xué)位論文 前1條
1 田琪;內(nèi)在，，他人及環(huán)境歸因問卷的中文版修訂及與腦r-fMRI信號的相關(guān)研究[D];浙江大學(xué);2012年
本文編號：2506734
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