From the Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD.
Department of Psychology, University of Georgia, Athens, GA.
J Clin Psychopharmacol. 2021;41(3):236-243. doi: 10.1097/JCP.0000000000001397.
A significant proportion of people with schizophrenia are characterized by impaired ability to socially engage with others. The development of effective interventions for social functioning remains a central therapeutic challenge. Cognitive-behavioral social skills training (CBSST) has been found to improve social functioning in schizophrenia, but with only medium effect sizes. Intranasal oxytocin also has prosocial effects, but also only with modest effect sizes. This study assessed whether the addition of intranasal oxytocin to CBSST can strengthen their impact on social function.
Participants (N = 62) with schizophrenia or schizoaffective disorder entered a 24-week, double-blind, placebo-controlled, randomized clinical trial with a 3-month follow-up evaluation at 2 sites: Maryland and San Diego. Participants were randomized to either intranasal oxytocin 36 IU (3 sprays) twice a day (n = 31) or intranasal placebo-oxytocin (3 sprays) twice a day (n = 31). All participants received CBSST plus a social cognition skills training module (48 total sessions).
There were no significant treatment group differences in social functioning, positive symptoms, negative symptoms, defeatist beliefs, or asocial beliefs. The interpretation of treatment effects was complicated by site effects, whereby participants in San Diego began the trial with greater severity of impairments and subsequently showed greater improvements compared with participants in Maryland.
The results did not support the utility of add-on intranasal oxytocin to psychosocial rehabilitation interventions like CBSST for improvement in social function (ClinicalTrials.gov trial number: NCT01752712).
相当一部分精神分裂症患者的社交能力受损。开发有效的社交功能干预措施仍然是治疗的主要挑战。认知行为社会技能训练(CBSST)已被证明可以改善精神分裂症患者的社交功能,但效果只有中等。鼻内催产素也有亲社会作用,但效果也只有适度。本研究评估了鼻内催产素联合 CBSST 是否可以增强其对社会功能的影响。
62 名精神分裂症或分裂情感障碍患者参加了一项为期 24 周的双盲、安慰剂对照、随机临床试验,在马里兰州和圣地亚哥的 2 个地点进行了 3 个月的随访评估。参与者随机分为鼻内催产素 36IU(3 喷),每天 2 次(n=31)或鼻内安慰剂催产素(3 喷),每天 2 次(n=31)。所有参与者均接受 CBSST 加社会认知技能训练模块(共 48 次)。
社会功能、阳性症状、阴性症状、失败信念和非社交信念方面,治疗组之间没有显著差异。由于地点效应,治疗效果的解释变得复杂,圣地亚哥的参与者在试验开始时的损伤程度更严重,随后的改善程度也比马里兰州的参与者更大。
结果不支持鼻内催产素作为 CBSST 等心理社会康复干预措施的附加物,用于改善社会功能(ClinicalTrials.gov 试验编号:NCT01752712)。