Lu Hongbo, Li Yuying, Li Feng, Jiao Xinyi, Shi Wen, Guo Kanglin, Liu Pengfei
Third People's Hospital of Lanzhou Municipality, Lanzhou, Gansu Province, China.
Lanzhou Hospital, Gansu Province Prison Administration, Lanzhou, Gansu Province, China.
Shanghai Arch Psychiatry. 2012 Jun;24(3):149-54. doi: 10.3969/j.issn.1002-0829.2012.03.004.
Cognitive remediation therapy (CRT) is one of the promising new non-drug approaches to reducing cognitive deficits of patients with schizophrenia that has not yet been fully evaluated in China.
Assess the efficacy of CRT in improving the cognitive functioning, social functioning and insight of patients with chronic schizophrenia.
126 clinically stable inpatients with chronic schizophrenia were randomly allocated to an intervention group (with CRT) and a treatment as usual group (TAU) (which used standard occupational and recreational therapy methods). The treatment frequency and duration were the same for the two groups: five times per week for three months. The Wisconsin Card Sorting Test (WCST) was used to evaluate before versus after changes in cognitive function, the Scale of Social Skills of chronic schizophrenia Inpatients (SSSI) was used to assess social functioning, and the Insight and Treatment Attitude Questionnaire (ITAQ) was use to assess insight.
Four patients dropped out during the study leaving 60 in the CRT group and 62 in the TAU group in the final analysis. Both groups showed significant improvement in WCST measures over the three-month trial but the improvement in the CRT group was significantly greater than that for the TAU group on all of the WCST measures assessed. The total SSSI score improved significantly in both groups over the three months, but the improvement in the two groups was not significantly different. The total ITAQ score also showed significant improvement in both groups over the three months and the degree of improvement was significantly greater in the CRT group than in the TAU group.
As an adjunctive treatment to antipsychotic medication, a three month course of CRT is more effective at improving the cognitive functioning and insight of hospitalized patients with chronic schizophrenia than routine occupational and recreational therapy.
认知康复治疗（CRT）是一种有前景的新型非药物治疗方法，用于减少精神分裂症患者的认知缺陷，但在中国尚未得到充分评估。
评估CRT对改善慢性精神分裂症患者认知功能、社会功能和自知力的疗效。
将126例临床症状稳定的慢性精神分裂症住院患者随机分为干预组（接受CRT）和常规治疗组（TAU，采用标准的职业和娱乐治疗方法）。两组的治疗频率和疗程相同：每周5次，共3个月。采用威斯康星卡片分类测验（WCST）评估认知功能的前后变化，采用慢性精神分裂症住院患者社会技能量表（SSSI）评估社会功能，采用自知力与治疗态度问卷（ITAQ）评估自知力。
研究期间有4例患者退出，最终分析时CRT组有60例，TAU组有62例。在为期3个月的试验中，两组的WCST各项指标均有显著改善，但CRT组在所有评估的WCST指标上的改善均显著大于TAU组。在3个月内，两组的SSSI总分均显著改善，但两组间改善无显著差异。两组的ITAQ总分在3个月内也均显著改善，且CRT组的改善程度显著大于TAU组。
作为抗精神病药物的辅助治疗，为期3个月的CRT疗程在改善住院慢性精神分裂症患者的认知功能和自知力方面比常规职业和娱乐治疗更有效。
