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团体认知行为疗法对中国精神障碍患者的疗效:一项可行性对照研究。

Group cognitive behavioural therapy for Chinese patients with psychotic disorder: A feasibility controlled study.

机构信息

Clinical Psychology Service, Department of Psychiatry, Kowloon Hospital, HKSAR, Hong Kong.

Clinical Psychology Service, Department of Psychiatry, Kowloon Hospital, HKSAR, Hong Kong.

出版信息

Asian J Psychiatr. 2019 Jan;39:157-164. doi: 10.1016/j.ajp.2018.12.015. Epub 2018 Dec 26.

Abstract

AIM

Evidence for the effectiveness of individual cognitive behavioural therapy for psychosis (CBTp) is promising but evidence for presenting CBTp in a group setting and in the Asian context is limited. The present study is to evaluate the feasibility and effectiveness of Group CBTp in clinical practice.

METHOD

Forty-eight out-patients and day-patients with the schizophrenia spectrum disorders were recruited and randomly assigned to the group CBTp plus treatment as usual (TAU), or psychoeducation group (PsyEdI) plus TAU. Both interventions consisted of 7 consecutive weekly sessions with a booster session 4 weeks after the last session. Patients were assessed on outcome measures such as the Psychotic Symptom Rating Scales (PSYRATS), the Beck Depression Inventory (BDI), a Chinese version of the Beliefs About Voice Questionnaire-Revised version (BAVQ-R), at baseline and after treatment.

RESULTS

Patients received group CBTp (n = 25) showed significantly greater improvement in their delusion compared with those receiving PsyEdI (n = 23). Nearly 61% of patients in the group CBTp showed at least 50% reduction on their score of delusion in the PSYRATS. Group CBTp was also found to be effective in reducing patients' dysfunctional beliefs towards voices, especially in the subscale of benevolence and omnipotence, their conviction on delusion, as well as their distress from positive psychotic symptoms.

CONCLUSION

Group CBTp can be an effective adjunctive psychological intervention in improving positive psychotic experiences among people with persistent psychotic symptoms, and can be applied in routine clinical practice.

摘要

目的

个体认知行为疗法治疗精神病(CBTp)的有效性证据令人鼓舞,但在群体环境中以及在亚洲背景下提供 CBTp 的证据有限。本研究旨在评估团体认知行为疗法在临床实践中的可行性和有效性。

方法

招募了 48 名精神分裂症谱系障碍的门诊和日间患者,并将他们随机分配到团体认知行为疗法加常规治疗(TAU)组或心理教育组(PsyEdI)加 TAU 组。两种干预措施均包括连续 7 周的每周一次治疗,并在最后一次治疗后 4 周进行一次强化治疗。患者在基线和治疗后接受精神病症状评定量表(PSYRATS)、贝克抑郁量表(BDI)和中文版幻听信念问卷修订版(BAVQ-R)等疗效评估。

结果

接受团体认知行为疗法(n=25)的患者在妄想方面的改善明显优于接受心理教育(n=23)的患者。接受团体认知行为疗法的患者中,近 61%的患者在 PSYRATS 上的妄想得分至少降低了 50%。团体认知行为疗法还被发现可有效减少患者对幻听的不良信念,特别是在仁慈和全能、妄想信念以及阳性精神病症状引起的痛苦等子量表上。

结论

团体认知行为疗法可以作为一种有效的辅助心理干预手段,改善持续性精神病症状患者的阳性精神病体验,可在常规临床实践中应用。

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