La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland,
La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland.
Psychother Psychosom. 2019;88(2):84-95. doi: 10.1159/000496479. Epub 2019 Feb 18.
Negative symptoms are frequent in patients with schizophrenia and are associated with marked impairments in social functioning. The efficacy of drug-based treatments and psychological interventions on primary negative symptoms remains limited. The Positive Emotions Programme for Schizophrenia (PEPS) is designed to improve pleasure and motivation in schizophrenia patients by targeting emotion regulation and cognitive skills relevant to apathy and anhedonia. The main hypothesis of this study is that patients who attend 8 one-hour sessions of PEPS and treatment as usual (TAU) will have lower total apathy-avolition and anhedonia-asociality composite scores on the Scale for the Assessment of Negative Symptoms (SANS) than patients who attend only TAU.
Eighty participants diagnosed with schizophrenia or schizoaffective disorder were randomized to receive either TAU or PEPS + TAU. The participants were assessed by independent evaluators before randomization (T0), in a post-test after 8 weeks of treatment (T1) and at a 6-month follow-up (T2).
The post-test results and 6-month follow-up assessments according to an intention-to-treat analysis showed that the apathy and anhedonia composite scores on the SANS indicated statistically greater clinical improvements in PEPS participants than in non-PEPS participants. In the post-test, anhedonia but not apathy was significantly improved, thus favouring the PEPS condition. These results were sustained at the 6-month follow-up.
PEPS is an effective intervention to reduce anhedonia in schizophrenia. PEPS is a short, easy-to-use, group-based, freely available intervention that is easy to implement in a variety of environments (ClinicalTrials.gov ID: NCT02593058).
精神分裂症患者常出现阴性症状，且与社会功能严重受损有关。基于药物的治疗和心理干预对原发性阴性症状的疗效仍然有限。精神分裂症积极情绪计划（PEPS）旨在通过针对与淡漠和快感缺失相关的情绪调节和认知技能来改善精神分裂症患者的愉悦感和动机。本研究的主要假设是，与仅接受 TAU 的患者相比，参加 8 次 1 小时的 PEPS 和 TAU 的患者在负面症状评估量表（SANS）上的总淡漠-意志减退和快感缺失-社会性复合评分会更低。
80 名被诊断为精神分裂症或分裂情感障碍的参与者被随机分配接受 TAU 或 PEPS+TAU。参与者在随机分组前（T0）、8 周治疗后的后测（T1）和 6 个月随访（T2）时由独立评估者进行评估。
根据意向治疗分析的后测结果和 6 个月随访评估显示，SANS 的淡漠和快感缺失复合评分表明 PEPS 组患者的临床改善明显优于非 PEPS 组患者。在后测中，快感缺失而非淡漠显著改善，因此有利于 PEPS 条件。这些结果在 6 个月的随访中得到了维持。
PEPS 是一种减少精神分裂症快感缺失的有效干预措施。PEPS 是一种简短、易用、基于小组、免费的干预措施，易于在各种环境中实施（ClinicalTrials.gov ID：NCT02593058）。
