Serruya Gail, Grant Paul
School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
J Clin Psychol. 2009 Aug;65(8):791-802. doi: 10.1002/jclp.20616.
Central to psychotic disorders, delusions are associated with disability and often respond inadequately to pharmacotherapy. Cognitive-behavioral treatments have been developed over the last 20 years that successfully address delusions. However, meta-analyses suggest only a modest improvement in psychotic symptoms. Because delusions share considerable overlap with anxiety, adapting principles and techniques that have demonstrated efficacy in the treatment of anxiety disorders might improve the impact of cognitive-behavioral treatment of delusions. We report a case illustrating a cognitive-behavioral approach to delusions with an emphasis on mental imagery techniques. A 25-year-old male diagnosed with paranoid schizophrenia whose clinical presentation was dominated by paranoid delusions received 6 months of treatment. At the end of the follow-up period, the patient's delusions were minimal and his negative symptoms had significantly improved. Mental imagery may be an important treatment tool for delusions.
妄想是精神障碍的核心症状，与功能残疾相关，且对药物治疗的反应往往不佳。在过去20年里，已经开发出了成功治疗妄想的认知行为疗法。然而，荟萃分析表明，这些疗法只能使精神症状有适度改善。由于妄想与焦虑有相当大的重叠，采用已证明对焦虑症治疗有效的原则和技术，可能会提高认知行为疗法对妄想的治疗效果。我们报告一例病例，该病例展示了一种以心理意象技术为重点的针对妄想的认知行为疗法。一名25岁被诊断为偏执型精神分裂症的男性，其临床表现以偏执妄想为主，接受了6个月的治疗。在随访期结束时，患者的妄想症状基本消失，阴性症状也有显著改善。心理意象可能是治疗妄想的一种重要工具。
