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香港首发精神病患者社会认知与互动训练的随机对照试验。

A randomized controlled trial of social cognition and interaction training for persons with first episode psychosis in Hong Kong.

作者信息

Lo Panmi M T, Lui Simon S Y, Law Colin K M, Roberts David L, Siu Andrew M H

机构信息

Department of Occupational Therapy, Castle Peak Hospital, Hong Kong, Hong Kong SAR, China.

Department of Psychiatry, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.

出版信息

Front Psychiatry. 2023 Mar 6;14:1098662. doi: 10.3389/fpsyt.2023.1098662. eCollection 2023.

Abstract

Social cognitive impairment is a core limiting factor of functional recovery among persons with first episode psychosis (FEP). Social Cognition and Interaction Training (SCIT) is a group-based, manualized training with demonstrated evidence in improving social cognitive performance among people with schizophrenia. However, there are few studies on the effect of SCIT for people with FEP and for people in non-Western societies. This study evaluated the feasibility, acceptability and initial effectiveness of the locally-adapted SCIT in improving social cognitive functioning in Chinese people with FEP. The SCIT was delivered two sessions per week over a 10-weeks period, each session lasted for 60-90 min. A total of 72 subjects with FEP were recruited from an outpatient clinic and randomized to conventional rehabilitation ("Rehab") and experimental ("SCIT and Rehab") groups. Primary outcome measures included four social cognitive domains including emotion perception, theory-of-mind, attributional bias and jumping-to-conclusion, and secondary measures included neurocognition, social competence and quality of life. Participants were assessed at baseline, post-treatment, and 3-months post-treatment. Repeated measures ANCOVAs, with baseline scores as covariates, were used to compare the group differences in various outcomes across time. The results showed that the SCIT was well-accepted, with a satisfactory completion rate and subjective ratings of relevance in the experimental group. Moreover, treatment completers ( = 28) showed evidence of an advantage, over conventional group ( = 31), in reduced attributional bias and jumping-to-conclusions at treatment completion, lending initial support for the SCIT in Chinese people with FEP. Future research should address the limitations of this study, using more refined outcome measurements and higher treatment intensity of the SCIT.

摘要

社会认知障碍是首发精神病(FEP)患者功能恢复的核心限制因素。社会认知与互动训练(SCIT)是一种基于小组的、有手册指导的训练,已被证明能改善精神分裂症患者的社会认知表现。然而,关于SCIT对FEP患者以及非西方社会人群影响的研究较少。本研究评估了本地化改编的SCIT在中国FEP患者中改善社会认知功能的可行性、可接受性和初步有效性。SCIT在10周内每周进行两次,每次持续60 - 90分钟。共有72名FEP患者从门诊招募,并随机分为传统康复组(“康复组”)和实验组(“SCIT与康复组”)。主要结局指标包括四个社会认知领域,即情绪感知、心理理论、归因偏差和仓促下结论,次要指标包括神经认知、社交能力和生活质量。参与者在基线、治疗后和治疗后3个月进行评估。采用重复测量协方差分析,以基线分数作为协变量,比较各时间点不同结局的组间差异。结果表明,SCIT在实验组中被广泛接受,完成率令人满意且主观相关性评分较高。此外,治疗完成者(= 28)在治疗结束时显示出相较于传统组(= 31)在减少归因偏差和仓促下结论方面的优势,为SCIT在中国FEP患者中的应用提供了初步支持。未来的研究应解决本研究的局限性,采用更精细的结局测量方法和更高强度的SCIT治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a49/10029102/570f5e00a32f/fpsyt-14-1098662-g001.jpg

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