短程认知行为治疗改善精神分裂症患者生活质量的效果及影响因素
The efficacy and influence factors of brief cognitive-behavioral therapy in improving the quality of life of patients with schizophrenia
投稿时间:2024-02-02  修订日期:2024-06-27
DOI:
中文关键词:  精神分裂症  认知行为治疗  生活质量  影响因素
英文关键词:Schizophrenia  Cognitive behavioral therapy  Quality of life  Influence factor
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作者单位地址
孙倩 首都医科大学附属北京安定医院 北京市西城区德外安康胡同5号北京安定医院
杨晓婕* 首都医科大学附属北京安定医院 北京市西城区安康胡同5号
马云 首都医科大学附属北京安定医院 
郭志华 中国康复研究中心 
李占江 首都医科大学附属北京安定医院 
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中文摘要:
      背景 精神分裂症病程迁延,患者社会功能受损、生活质量明显降低,药物治疗联合心理治疗对患者生活质量的改善尤为重要。短程认知行为治疗(BCBT)已广泛应用于临床,但目前有关BCBT的研究更多关注患者症状的改善,缺少对生活质量改善的相关报道。目的 评价BCBT联合常规治疗对改善精神分裂症患者生活质量的效果及影响因素。方法 选取2011年8月-2016年12月在首都医科大学附属北京安定医院门诊随诊、符合《国际疾病分类(第10版)》(ICD-10)精神分裂症诊断标准的患者。采用随机数字表法将患者分为研究组和对照组各105例。两组均接受常规治疗,研究组在此基础上接受为期12周、共8次BCBT。在基线期和治疗12周末、随访26周末、随访52周末,采用阳性和阴性症状量表(PANSS)、个体和社会功能量表(PSP)以及世界卫生组织生存质量测定量表简表(WHOQOL-BREF)进行评估。结果 重复测量方差分析结果显示,PANSS总评分的时点效应、时点与组间的交互效应均有统计学意义(F=118.783、8.083,P均<0.01);PSP总评分的时点效应、组间效应以及时点与组间的交互效应均有统计学意义(F=94.358、4.048、5.490,P<0.01或0.05);WHOQOL-BREF总评分的时点效应、组间效应以及时点与组间的交互效应均有统计学意义(F=12.330、4.168、4.142,P<0.01或0.05),生理因子分的时点效应、时点与组间的交互效应均有统计学意义(F=6.597、3.649,P<0.01或0.05),心理因子分的时点效应具有统计学意义(F=9.909,P<0.01),社会关系因子分的时点效应具有统计学意义(F=9.451,P<0.01),环境因子分的时点效应、组间效应以及时点与组间的交互效应均有统计学意义(F=7.486、6.983、2.891,P<0.01或0.05)。二元logistic回归分析显示研究组(OR=1.861、95% CI:1.004~3.448)、年龄小(OR=1.044、95% CI:1.001~1.088)是患者生活质量改善的保护因素,PANSS基线评分高(OR=0.972、95% CI:0.945~0.999)是患者生活质量改善的危险因素。结论 BCBT联合常规治疗对改善精神分裂症患者生活质量的起效更早,长期疗效优于常规治疗。
英文摘要:
      Background The course of schizophrenia is prolonged, and patients have impaired social function and significantly reduced quality of life. Drug therapy combined with psychological therapy is particularly important for improving the quality of life of patients. Brief cognitive-behavioral therapy (BCBT) has been widely applied in clinical practice, but current research on BCBT focuses more on improving patient symptoms and lacks relevant reports on improving quality of life. Objective To evaluate the effect and influencing factors of BCBT combined with conventional treatment on improving the quality of life in patients with schizophrenia. Methods Select patients who met the diagnostic criteria for schizophrenia in the International Classification of Diseases (10th edition) (ICD-10) and were followed up at the outpatient department of Beijing Anding Hospital affiliated with Capital Medical University from August 2011 to December 2016. Using a random number table method, patients were divided into a study group and a control group, with 105 cases in each group. Both groups received routine treatment, and the research group received a total of 8 BCBT sessions for 12 weeks on this basis. During the baseline period and 12 weeks of treatment, 26 weeks of follow-up, and 52 weeks of follow-up, positive and negative symptom scales (PANSS), individual and social function scales (PSP), and the World Health Organization Quality of Life Scale Brief (WHO QOL-BREF) were used for evaluation. Results The results of repeated measures analysis of variance showed that the time point effect and interaction effect of PANSS total score were statistically significant (F=118.783, 8.083, P<0.01); the time point effect, inter group effect, and interaction effect of PSP total score were statistically significant (F=94.358, 4.048, 5.490, P<0.01 or 0.05); The time point effect, inter group effect, and interaction effect of the total score of the WHOQOL-BREF scale were all statistically significant (F=12.330, 4.168, 4.142, P<0.01 or 0.05), the time point effect and interaction effect of the physiological factor score were all statistically significant (F=6.597, 3.649, P<0.01 or 0.05), the time point effect of the psychological factor score was statistically significant (F=9.909, P<0.01), the time point effect of the social relationship factor score was statistically significant (F=9.451, P<0.01), and the time point effect, intergroup effect, and interaction effect of the environmental factor score were all statistically significant (F=7.486, 6.983, 2.891, P<0.01 or 0.05). Binary logistic regression analysis showed that the study group (OR=1.861、95%CI:1.004~3.448) and young age (OR=1.044、95%CI:1.001~1.088) were protective factors for improving patient quality of life, while high PANSS baseline score (OR=0.972、95%CI:0.945~0.999) was a risk factor for improving patient quality of life. Conclusion The combination of BCBT and conventional treatment has an earlier onset of improvement in the quality of life of patients with schizophrenia, and long-term efficacy is superior to conventional treatment.
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