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认知行为疗法对伴有睡眠障碍的精神分裂症患者失眠的影响:一项非随机、评估者盲法试验。

The effect of cognitive behavioral therapy for insomnia in schizophrenia patients with sleep Disturbance: A non-randomized, assessor-blind trial.

机构信息

Department of Psychiatry, Seoul Metropolitan Eunpyeong Hospital, Republic of Korea.

Department of Psychiatry, Seoul Metropolitan Eunpyeong Hospital, Republic of Korea.

出版信息

Psychiatry Res. 2019 Apr;274:182-188. doi: 10.1016/j.psychres.2019.02.002. Epub 2019 Feb 3.

Abstract

This non-randomized, assessor blind study evaluated the effects of cognitive behavioral therapy for insomnia (CBT-I) delivered in a group format on insomnia symptoms as well as psychotic, depressive, and anxiety symptoms in schizophrenia patients (n = 63) recruited from residential or rehabilitative facilities in Seoul, South Korea. Thirty-one patients received four sessions of CBT-I in groups of 2-9 patients in addition to usual care, while the control group (n = 32) received no additional intervention. The Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI), Psychotic Symptoms Rating Scale (PSYRATS), Anxiety Sensitivity Index (ASI), and Beck Depression Inventory (BDI) were administered at baseline, week 4, and week 8. Both groups showed significant time-group interactions on the ISI and PSQI. Post hoc testing showed that, compared to the control group, the CBT-I group showed significant reductions in ISI and PSQI at both week 4 and week 8. For the PSYRATS, ASI, and BDI scores, the CBT-I and control groups showed significant time-group interactions, but post hoc testing revealed no significant group differences at either week 4 or week 8. Therefore, CBT-I was effective for reducing insomnia symptoms in patients with schizophrenia and the effect lasted for 4 weeks after the intervention.

摘要

这项非随机、评估者盲法研究评估了在韩国首尔的住宅或康复设施中招募的精神分裂症患者(n=63)以小组形式接受认知行为疗法治疗失眠(CBT-I)对失眠症状以及精神病、抑郁和焦虑症状的影响。31 名患者在常规治疗的基础上接受了 4 次 2-9 名患者的小组 CBT-I,而对照组(n=32)未接受任何额外干预。在基线、第 4 周和第 8 周时,使用失眠严重程度指数(ISI)和匹兹堡睡眠质量指数(PSQI)、精神病症状评定量表(PSYRATS)、焦虑敏感指数(ASI)和贝克抑郁量表(BDI)进行评估。两组在 ISI 和 PSQI 上均表现出显著的时间-组间交互作用。事后检验显示,与对照组相比,CBT-I 组在第 4 周和第 8 周时 ISI 和 PSQI 显著降低。对于 PSYRATS、ASI 和 BDI 评分,CBT-I 和对照组均表现出显著的时间-组间交互作用,但事后检验显示在第 4 周或第 8 周时两组之间均无显著差异。因此,CBT-I 可有效减轻精神分裂症患者的失眠症状,且干预结束后 4 周内效果持续。

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