| 孙倩,杨晓婕,马云,郭志华,李占江.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[J].四川精神卫生杂志,2024,37(3):219-225.Sun Qian,Yang Xiaojie,Ma Yun,Guo Zhihua,Li Zhanjiang,Efficacy of brief cognitive behavioral therapy on improving quality of life improvement in patients with schizophrenia[J].SICHUAN MENTAL HEALTH,2024,37(3):219-225 |
| 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 |
| Efficacy of brief cognitive behavioral therapy on improving quality of life improvement in patients with schizophrenia |
| 投稿时间：2024-02-02 |
| DOI：10.11886/scjsws20240202003 |
| 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 Influencing factors |
| 基金项目:北京市科委资助科研项目（项目名称：首发精神分裂症患者认知行为治疗效果评价研究，项目编号：Z111107058811078）；首都医学发展基金联合攻关项目（项目名称：精神分裂症社区CBT操作程式的效果评价研究，项目编号：2009-1050）；北京市卫生与健康科技成果和适宜技术推广项目（项目名称：短程认知行为治疗在精神分裂症社区康复中的推广，项目编号：TG-2017-38） |
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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210例。采用随机数字表法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）进行评定。结果 重复测量方差分析结果显示，PANSS总评分的时间效应、时间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总评分的时间效应、组间效应以及时间与组间的交互效应均有统计学意义（F=94.358、4.048、5.490，P<0.05或0.01）；WHOQOL-BREF总评分的时间效应、组间效应以及时间与组间的交互效应均有统计学意义（F=12.330、4.168、4.142，P<0.05或0.01）。二元Logistic回归分析显示，BCBT联合常规治疗（OR=1.861，95% CI：1.004~3.448）、年龄小（OR=1.044，95% CI：1.001~1.088）是精神分裂症患者生活质量改善的保护因素，基线期PANSS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 与常规治疗相比，BCBT联合常规治疗对改善精神分裂症患者生活质量的效果显现更早，且长期效果更好。 |
| 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 patients' symptoms and lacks relevant reports on improving quality of life.Objective To evaluate the efficacy and influencing factors of BCBT combined with conventional treatment on improving the quality of life in patients with schizophrenia.Methods A total of 210 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 Capital Medical University from August 2011 to December 2016 were selected. Using a random number table method， patients were divided into study group and 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. At the baseline period and 12 weeks of treatment， 26 weeks of follow-up and 52 weeks of follow-up， Positive and Negative Syndrome Scale （PANSS）， Personal and Social Performance Scale （PSP） and World Health Organization Quality of Life Brief （WHOQOL-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<0.05 or 0.01）. The time point effect， inter group effect and interaction effect of the total score of WHOQOL-BREF were all statistically significant （F=12.330， 4.168， 4.142， P<0.05 or 0.01） 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 quality of life of patients， while high PANSS baseline score （OR=0.972， 95% CI： 0.945~0.999） was a risk factor for improving quality of life of patients.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.［Funded by Research Projects Supported by Beijing Municipal Commission of Science and Technology （number， Z111107058811078）； Capital Medical Development Fund Joint Research Project （number， 2009-1050）； Beijing Hygienism and Health Science and Technology Achievements and Appropriate Technology Promotion Project （number， TG-2017-38）； www.chictr.org.cn number： ChiCTR-TRC-13003709］ |
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