精神分裂症患者离线与在线团体元认知训练的实证研究
An empirical study of offline and online group metacognitive training in patients with schizophrenia.
作者信息
Zhang Yanping, He Shouxun, Zhang Xue, Zhou Yue, Qiu Yuhua, Wang Hailing, Cheng Jie, Wang Chuansheng, Yan Fang
机构信息
Department of Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, Henan, 453000, China.
Xinxiang Key Laboratory of Mental Rehabilitation, Henan, 453000, China.
出版信息
BMC Psychiatry. 2025 May 30;25(1):553. doi: 10.1186/s12888-025-06968-0.
BACKGROUND
Schizophrenia often has hallucinations, delusions and other complex mental symptoms, metacognitive training (MCT) is a type of low-intensity group training. However, MCT requires a lot of time and expense, increasing the workload of professionals and the financial burden of patients. hybrid offline-online MCT reduces time and economic costs to the greatest extent. This study was designed to validate the interventional effects of a hybrid offline-online MCT model on psychiatric symptoms, delusion severity, and insight in patients with schizophrenia, while concurrently evaluating its clinical applicability.
METHODS
Randomized controlled trials comparing hybrid offline-online MCT were conducted in patients with paranoid schizophrenia. The positive and negative syndrome scale (PANSS), the Chinese version of the delusion feature rating scale (C-CDRS), the Chinese version of the psychotic symptom rating scale (PSYRATS), and the insight and treatment attitude questionnaire (ITAQ) were used to evaluate psychiatric symptom improvement and insight in the baseline (T0), 4 weeks after the initiation of training (T1), and upon completion of the training (T2, week 8).
RESULTS
The total scores of PANSS, C-CDRS, PSYRATS, and their subscale scores in the MCT and control groups were lower than baseline scores at weeks four and eight, while the total ITAQ score was higher than baseline scores (P < 0.01). In the MCT group, PANSS positive subscale and total score, C-CDRS total score, and PSYRATS delusion subscale and total score were lower than those in the control group at weeks four and eight, whereas the ITAQ total score was higher than the baseline score (P < 0.01).
CONCLUSIONS
Hybrid offline-online group MCT can reduce positive symptoms in patients with schizophrenia, alleviate delusions, and improve patients' insight.
TRIAL REGISTRATION
The trial was registered at the Chinese Clinical Trial Registry on 01/24/2015 ( www.chictr.org.cn ; ChiCTRID: ChiCTR2500096505).
背景
精神分裂症常伴有幻觉、妄想等复杂精神症状，元认知训练（MCT）是一种低强度团体训练。然而，MCT需要大量时间和费用，增加了专业人员的工作量和患者的经济负担。线上线下混合式MCT能最大程度降低时间和经济成本。本研究旨在验证线上线下混合式MCT模式对精神分裂症患者精神症状、妄想严重程度及自知力的干预效果，同时评估其临床适用性。
方法
对偏执型精神分裂症患者进行比较线上线下混合式MCT的随机对照试验。采用阳性与阴性症状量表（PANSS）、中文版妄想特征评定量表（C-CDRS）、中文版精神病性症状评定量表（PSYRATS）以及自知力与治疗态度问卷（ITAQ），在基线期（T0）、训练开始后4周（T1）以及训练结束时（T2，第8周）评估精神症状改善情况及自知力。
结果
在第4周和第8周时，MCT组和对照组的PANSS、C-CDRS、PSYRATS总分及其各子量表得分均低于基线得分，而ITAQ总分高于基线得分（P＜0.01）。在MCT组，第4周和第8周时，PANSS阳性子量表及总分、C-CDRS总分、PSYRATS妄想子量表及总分均低于对照组，而ITAQ总分高于基线得分（P＜0.01）。
结论
线上线下混合式团体MCT可减轻精神分裂症患者的阳性症状，缓解妄想，并改善患者的自知力。
试验注册
该试验于2015年1月24日在中国临床试验注册中心注册（www.chictr.org.cn；注册号：ChiCTR2500096505）。
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