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一项关于认知行为综合心理治疗方案的为期十二周的随机对照研究:对精神分裂症患者社会功能的积极影响。

A twelve-week randomized controlled study of the cognitive-behavioral Integrated Psychological Therapy program: positive effect on the social functioning of schizophrenic patients.

作者信息

Zimmer Marilene, Duncan Adriana Veríssimo, Laitano Daniela, Ferreira Eloisa Elena, Belmonte-de-Abreu Paulo

机构信息

Social Psychiatry, Schizophrenia Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre (RS), Brazil.

出版信息

Braz J Psychiatry. 2007 Jun;29(2):140-7. doi: 10.1590/s1516-44462006005000030.

Abstract

OBJECTIVES

The present study was designed to evaluate the effect of twelve weekly sessions of the cognitive-behavioral program originally known as the Integriertes Psychologisches Therapieprogramm für Schizophrene Patienten, designated the Integrated Psychological Therapy (IPT) program in English, on cognition, social adjustment and quality of life in schizophrenic outpatients, comparing it to the effect of treating such patients as usual.

METHOD

Fifty-six adult outpatients (from 18 to 65 years of age) with ICD-10-based diagnoses of schizophrenia were randomly assigned to two different groups: active intervention (IPT group); and treatment as usual (control group). Outcome measures were quality of life (as determined using the WHOQOL-Bref), cognition (Mini-Mental State Examination and Word Recall Test), global functioning (DSM-IV Global Assessment of Functioning Scale), social functioning (Social and Occupational Functioning Assessment Scale) and social adjustment (Social Adjustment Scale).

RESULTS

The findings suggest that, in comparison with treatment as usual (control group), the twelve-session IPT program had a positive effect on several outcome measures: cognition in the domains of spatiotemporal orientation (p = 0.051) and memory (p = 0.031); overall social adjustment (p = 0.037), leisure/social life (p = 0.051) and family relations (p = 0.008); overall functioning (p = 0.000); social-occupational functioning (p = 0.000); and quality of life in the psychological domain (p = 0.021).

CONCLUSIONS

The twelve-session cognitive-behavioral IPT intervention demonstrated superiority over treatment as usual in its effects on cognition, social adjustment and quality of life. Studies involving larger samples, longer follow-up periods and additional outcome measures are needed in order to assess the specific effects on dimensions of social functioning, cognitive functioning and quality of life in patients with schizophrenia.

摘要

目的

本研究旨在评估最初称为Integriertes Psychologisches Therapieprogramm für Schizophrene Patienten(英文名为Integrated Psychological Therapy,简称IPT)的认知行为疗法每周十二次疗程,对精神分裂症门诊患者认知、社会适应和生活质量的影响,并与常规治疗此类患者的效果进行比较。

方法

56名基于ICD - 10诊断为精神分裂症的成年门诊患者(年龄在18至65岁之间)被随机分为两组:积极干预组(IPT组)和常规治疗组(对照组)。结果测量指标包括生活质量(使用WHOQOL - Bref确定)、认知(简易精神状态检查表和单词回忆测试)、整体功能(DSM - IV整体功能评估量表)、社会功能(社会和职业功能评估量表)以及社会适应(社会适应量表)。

结果

研究结果表明,与常规治疗(对照组)相比,十二次疗程的IPT项目对多个结果测量指标有积极影响:时空定向领域的认知(p = 0.051)和记忆(p = 0.031);整体社会适应(p = 0.037)、休闲/社交生活(p = 0.051)和家庭关系(p = 0.008);整体功能(p = 0.000);社会职业功能(p = 0.000);以及心理领域的生活质量(p = 0.021)。

结论

十二次疗程的认知行为IPT干预在对认知、社会适应和生活质量的影响方面优于常规治疗。需要开展涉及更大样本、更长随访期和更多结果测量指标的研究,以评估对精神分裂症患者社会功能、认知功能和生活质量维度的具体影响。

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