Hu Jian-Jun, Sun Xi-Rong, Ni Shuang-Ming, Kong Yan
Department of Psychiatry, Shanghai Pudong New Area Mental Health Center (Mental Health Center of Tongji University, Shanghai Pudong New Area Psychological Counseling Center), Shanghai 200124, China.
World J Psychiatry. 2024 Jun 19;14(6):884-893. doi: 10.5498/wjp.v14.i6.884.
BACKGROUND: Patients with schizophrenia may have various disease manifestations, most of which gradually tend toward incurable chronic decline, leading to mental disability. The basic symptoms of the disease can impair social function, whereas long-term hospitalization produces hospitalization syndrome, causing serious damage to social function. AIM: To investigate the effects of Computerized Cognitive Remediation Therapy (CCRT) on cognitive and social functioning in patients with chronic schizophrenia. METHODS: A retrospective analysis of 120 patients with chronic schizophrenia in Shanghai Pudong New Area Mental Health Center was performed. They were divided into an intervention group (60 cases treated with CCRT combined with conventional medication) and a control group (60 cases treated with conventional medication). After treatment, effects on cognitive function and social roles were observed in both groups. The Positive and Negative Syndrome Scale (PANSS) was used to assess the patients' psychiatric symptoms. The Wisconsin Card Sorting Test (WCST) was used to assess the patients' cognitive functioning, and the Social Functioning Scale for Psychiatric Inpatients (SSPI) was used to assess the social functioning of the inpatient psychiatric patients. RESULTS: No significant differences were observed in the PANSS, WCST, and SSPI intergroup scores before treatment ( > 0.05). After 2, 4, and 6 wk of therapy, general psychopathological factors, positive symptoms, negative symptoms, and total PANSS scores of PANSS in the intervention group were lower than in the control group ( < 0.05). After 2, 4, and 6 wk of treatment, the number of false responses, number of persistent bugs, and total responses in the WCST were significantly lower in the intervention group than in the control group ( < 0.05), and the amount of completed classification was significantly higher than in the control group ( < 0.05). After 2, 4, and 6 wk of therapy, the SSPI scores were significantly greater than those of the controls ( < 0.05). After 6 wk of treatment, the efficacy rates of the control and intervention groups were 81.67% and 91.67%, respectively. The curative effect in the intervention group was significantly higher than that in the control group ( < 0.05). CONCLUSION: CCRT can significantly improve cognitive function and social abilities in patients with chronic schizophrenia.
背景：精神分裂症患者可能有多种疾病表现，其中大多数逐渐趋于不可治愈的慢性衰退，导致精神残疾。该疾病的基本症状会损害社会功能，而长期住院会产生住院综合征，对社会功能造成严重损害。 目的：探讨计算机化认知康复治疗（CCRT）对慢性精神分裂症患者认知功能和社会功能的影响。 方法：对上海市浦东新区精神卫生中心120例慢性精神分裂症患者进行回顾性分析。将他们分为干预组（60例采用CCRT联合传统药物治疗）和对照组（60例采用传统药物治疗）。治疗后，观察两组对认知功能和社会角色的影响。采用阳性与阴性症状量表（PANSS）评估患者的精神症状。采用威斯康星卡片分类测验（WCST）评估患者的认知功能，采用精神科住院患者社会功能量表（SSPI）评估精神科住院患者的社会功能。 结果：治疗前，两组在PANSS、WCST和SSPI组间评分上无显著差异（>0.05）。治疗2、4和6周后，干预组PANSS的一般精神病理因子、阳性症状、阴性症状及PANSS总分均低于对照组（<0.05）。治疗2、4和6周后，干预组WCST的错误应答数、持续错误数及总应答数均显著低于对照组（<0.05），完成分类量显著高于对照组（<0.05）。治疗2、4和6周后，干预组SSPI评分显著高于对照组（<0.05）。治疗6周后，对照组和干预组的有效率分别为81.67%和91.67%。干预组的疗效显著高于对照组（<0.05）。 结论：CCRT可显著改善慢性精神分裂症患者的认知功能和社会能力。
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