Department of Psychology,University of Georgia,Athens, GA,USA.
VA San Diego Healthcare System, Department of Psychiatry,University of California San Diego School of Medicine,San Diego, CA,USA.
Psychol Med. 2019 Jul;49(10):1731-1739. doi: 10.1017/S0033291718002465. Epub 2018 Sep 5.
Individuals with schizophrenia have deficits in social cognition that are associated with poor functional outcome. Unfortunately, current treatments result in only modest improvement in social cognition. Oxytocin, a neuropeptide with pro-social effects, has significant benefits for social cognition in the general population. However, studies examining the efficacy of oxytocin in schizophrenia have yielded inconsistent results. One reason for inconsistency may be that oxytocin has typically not been combined with psychosocial interventions. It may be necessary for individuals with schizophrenia to receive concurrent psychosocial treatment while taking oxytocin to have the context needed to make gains in social cognitive skills.
The current study tested this hypothesis in a 24-week (48 session) double-blind, placebo-controlled trial that combined oxytocin and Cognitive-Behavioral Social Skills Training (CBSST), which included elements from Social Cognition and Interaction Training (SCIT). Participants included 62 outpatients diagnosed with schizophrenia (placebo n = 31; oxytocin n = 31) who received 36 IU BID, with supervised administration 45 min prior to sessions on CBSST group therapy days. Participants completed a battery of measures administered at 0, 12, and 24 weeks that assessed social cognition.
CBSST generally failed to enhance social cognition from baseline to end of study, and there was no additive benefit of oxytocin beyond the effects of CBSST alone.
Findings suggest that combined CBSST and oxytocin had minimal benefit for social cognition, adding to the growing literature indicating null effects of oxytocin in multi-dose trials. Methodological and biological factors may contribute to inconsistent results across studies.
精神分裂症患者的社会认知存在缺陷，这与较差的功能预后有关。不幸的是，目前的治疗方法仅能使社会认知得到适度改善。具有亲社会作用的神经肽催产素对普通人群的社会认知有显著益处。然而，研究检查催产素在精神分裂症中的疗效的结果并不一致。不一致的原因之一可能是催产素通常未与心理社会干预相结合。精神分裂症患者可能需要同时接受心理社会治疗，同时接受催产素治疗，以便在社会认知技能方面取得进步。
本研究在一项为期 24 周（48 次）的双盲、安慰剂对照试验中检验了这一假设，该试验将催产素与认知行为社会技能训练（CBSST）相结合，其中包括社会认知和互动训练（SCIT）的元素。参与者包括 62 名被诊断为精神分裂症的门诊患者（安慰剂 n = 31；催产素 n = 31），他们接受了 36 IU 每日两次的治疗，在 CBSST 团体治疗日的 45 分钟前进行监督管理。参与者在 0、12 和 24 周完成了一系列评估社会认知的测试。
CBSST 通常未能增强社会认知，从基线到研究结束，并且催产素除了单独 CBSST 的效果之外没有额外的益处。
研究结果表明，CBSST 和催产素联合治疗对社会认知的益处极小，这增加了越来越多的关于催产素在多剂量试验中无效的文献。方法学和生物学因素可能导致不同研究的结果不一致。
