Favrod Jérôme, Linder Sabrina, Pernier Sophie, Chafloque Mario Navarro
Department of Psychiatry, University Hospital Center and University of Lausanne, Site de Cery, CH-1008 Prilly, Switzerland.
Ann Gen Psychiatry. 2007 Aug 19;6:22. doi: 10.1186/1744-859X-6-22.
Two case studies are presented to examine how cognitive behavioural therapy (CBT) of auditory hallucinations can be fitted to mild and moderate intellectual disability.
A 38-year-old female patient with mild intellectual disability and a 44-year-old male patient with moderate intellectual disability, both suffering from persistent auditory hallucinations, were treated with CBT. Patients were assessed on beliefs about their voices and their inappropriate coping behaviour to them. The traditional CBT techniques were modified to reduce the emphasis placed on cognitive abilities. Verbal strategies were replaced by more concrete tasks using role-playing, figurines and touch and feel experimentation.
Both patients improved on selected variables. They both gradually managed to reduce the power they attributed to the voice after the introduction of the therapy, and maintained their progress at follow-up. Their inappropriate behaviour consecutive to the belief about voices diminished in both cases.
These two case studies illustrate the feasibility of CBT for psychotic symptoms with intellectually disabled people, but need to be confirmed by more stringent studies.
本文通过两个案例研究，探讨如何将针对幻听的认知行为疗法（CBT）应用于轻度和中度智力残疾患者。
一名38岁的患有轻度智力残疾的女性患者和一名44岁的患有中度智力残疾的男性患者，均患有持续性幻听，接受了认知行为疗法治疗。对患者关于幻听的信念以及针对幻听的不适当应对行为进行了评估。对传统的认知行为疗法技术进行了修改，以减少对认知能力的强调。用角色扮演、小雕像以及触摸和感觉实验等更具体的任务取代了言语策略。
两名患者在选定变量上均有改善。在引入治疗后，他们都逐渐成功降低了赋予幻听的力量，并在随访中保持了进展。在这两个案例中，与幻听信念相关的不适当行为均有所减少。
这两个案例研究说明了认知行为疗法治疗智障人士精神病症状的可行性，但需要更严格的研究加以证实。
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