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小组认知康复能否预防复发?:一项为期 1 年的随访随机对照试验结果。

Can Cognitive Remediation in Groups Prevent Relapses?: Results of a 1-Year Follow-up Randomized Controlled Trial.

机构信息

University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.

出版信息

J Nerv Ment Dis. 2020 May;208(5):362-370. doi: 10.1097/NMD.0000000000001146.

Abstract

International guidelines define relapse prevention for schizophrenia patients as a key therapeutic aim. However, approximately 80% to 90% of schizophrenia patients experience further symptom exacerbation after the first episode. The purpose of this study was to investigate whether group integrated neurocognitive therapy (INT), a cognitive remediation approach, reduces relapse rates in schizophrenia outpatients. INT was compared with treatment as usual (TAU) in a randomized controlled trial. Fifty-eight stabilized outpatients participated in the study with 32 allocated to the INT group and 26 to the TAU group. A test battery was used at baseline, posttreatment at 15 weeks, and a 1-year follow-up. Relapse rates were significantly lower in the INT condition compared with TAU during therapy as well as at follow-up. The relapse rate after therapy was associated with significant reductions in negative and general symptoms, improvements in functional outcome, and overall cognition. Out of these variables, negative symptoms were identified to show the strongest association with relapses after therapy. The primary outcome of this study suggests that INT can prevent relapses in schizophrenia outpatients.

摘要

国际指南将精神分裂症患者的复发预防定义为关键治疗目标。然而,大约 80%至 90%的精神分裂症患者在首次发作后会经历进一步的症状恶化。本研究旨在探讨团体综合神经认知疗法(INT)——一种认知矫正方法,是否会降低精神分裂症门诊患者的复发率。INT 在一项随机对照试验中与常规治疗(TAU)进行了比较。58 名稳定的门诊患者参与了这项研究,其中 32 名被分配到 INT 组,26 名被分配到 TAU 组。在基线、15 周治疗后和 1 年随访时使用了一套测试工具。与 TAU 相比,INT 组在治疗期间和随访期间的复发率显著降低。治疗后的复发率与阴性和一般症状的显著减轻、功能结果的改善以及整体认知能力的提高有关。在这些变量中,阴性症状被确定与治疗后复发有最强的关联。本研究的主要结果表明,INT 可以预防精神分裂症门诊患者的复发。

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