Wykes T, Parr A M, Landau S
Department of Psychology, Institute of Psychiatry, London.
Br J Psychiatry. 1999 Aug;175:180-5. doi: 10.1192/bjp.175.2.180.
Cognitive-behavioural therapy has been shown to be effective in reducing psychotic symptoms, but few patients have access to these services. Group cognitive treatment may provide a less costly service with similar benefits.
To explore the effectiveness of group cognitive-behavioural therapy on insight and symptoms, particularly auditory hallucinations.
Twenty-one DSM-IV diagnosed patients with schizophrenia with treatment-resistant, distressing auditory hallucinations were referred to a group programme consisting of six sessions of cognitive treatment following a strict protocol which emphasised individual power and control as well as coping strategies.
There were significant changes in all three main outcome measures following treatment; those changes were maintained at follow-up and were greater than changes over the waiting-list period. Specifically, there were changes in perceived power and distress as well as increases in the number and effectiveness of the coping strategies.
Group treatment for auditory hallucinations needs further investigation but does look promising and may provide a less costly alternative to individual cognitive treatment.
认知行为疗法已被证明在减轻精神病症状方面有效,但很少有患者能够获得这些服务。团体认知治疗可能提供成本较低且具有类似益处的服务。
探讨团体认知行为疗法对洞察力和症状,尤其是幻听的有效性。
21名被诊断为精神分裂症且对治疗有抵抗性、存在令人痛苦的幻听的DSM-IV患者被转介到一个团体项目,该项目包括按照严格方案进行的六次认知治疗课程,该方案强调个人力量和控制以及应对策略。
治疗后所有三项主要结局指标均有显著变化;这些变化在随访时得以维持,且大于等待期内的变化。具体而言,在感知到的力量和痛苦方面有变化,应对策略的数量和有效性也有所增加。
针对幻听的团体治疗需要进一步研究,但看起来很有前景,可能为个体认知治疗提供成本较低的替代方案。