Rector Neil A, Seeman Mary V, Segal Zindel V
Mood and Anxiety Program, Centre for Addiction and Mental Health, Clarke Division, University of Toronto, 250 College Street, Toronto, ON, Canada M5T 1R8.
Schizophr Res. 2003 Sep 1;63(1-2):1-11. doi: 10.1016/s0920-9964(02)00308-0.
The aim of the current study was to assess whether patients with a DSM-IV diagnosis of schizophrenia and experiencing persistent positive and negative symptoms improve with the addition of cognitive-behavioural therapy to enriched standard treatment.
A controlled study was completed with 42 patients randomized to either cognitive-behavioural therapy plus enriched treatment-as-usual (CBT-ETAU) (n = 24) or enriched treatment-as-usual only (ETAU) (n = 18). Enriched treatment-as-usual comprised comprehensive treatment within specialised schizophrenia treatment services. Cognitive-behavioural therapy was conducted on an individual basis for 6 months (20 sessions). Clinical assessments were done at pretreatment, posttreatment and at 6-month follow-up by raters blind to group allocation.
Significant clinical effects were observed for positive, negative and overall symptom severity for patients treated in CBT-ETAU, although there were no statistically significant differences between the treatment groups at posttreatment. The most pronounced effect of CBT-ETAU in comparison to ETAU in this study was in the reduction of negative symptoms at follow-up.
These results show promise for the impact of CBT on negative symptoms when explicitly targeted in treatment.
本研究的目的是评估被诊断为精神分裂症且存在持续阳性和阴性症状的患者，在强化标准治疗基础上增加认知行为疗法后症状是否改善。
完成了一项对照研究，42名患者被随机分为认知行为疗法加强化常规治疗组（CBT-ETAU）（n = 24）或仅强化常规治疗组（ETAU）（n = 18）。强化常规治疗包括在专门的精神分裂症治疗服务中进行综合治疗。认知行为疗法以个体为基础进行6个月（20次治疗）。由对分组情况不知情的评估者在治疗前、治疗后和6个月随访时进行临床评估。
CBT-ETAU组患者在阳性、阴性和总体症状严重程度方面观察到显著的临床效果，尽管治疗组在治疗后没有统计学上的显著差异。在本研究中，与ETAU相比，CBT-ETAU最显著的效果是在随访时减少了阴性症状。
这些结果表明，当在治疗中明确针对阴性症状时，认知行为疗法对其有改善作用。
