认知行为治疗对残疾精神障碍患者的康复疗效研究-现代医学

认知行为治疗对残疾精神障碍患者的康复疗效研究

作者：陈青松¹ 谢华¹ 岳莹莹² 陈素珍² 孙飞¹ 高敏¹ 羊健蓉¹ 曹霞¹ 陈凯明¹ 梅京斌¹ 刘萍¹ 吴雪梅¹ 王学娟¹ 殷婷

单位：1. 靖江市第二人民医院精神科, 江苏靖江 214500;
2. 东南大学附属中大医院心理精神科, 江苏南京 210009

分类号：R749

出版年·卷·期（页码）：2022·50·第一期（110-114）

摘要：

目的： 观察联合认知行为治疗(CBT)对残疾精神障碍患者的疗效。方法：共纳入80例经过严格评定为精神残疾的患者，随机分为对照组(常规治疗)和治疗组(常规治疗+CBT强化治疗)，每组40例。治疗4周，观察两组患者精神症状、认知功能、社会功能及残疾程度的改善情况。结果： 治疗前，两组患者简明精神病量表(BPRS)、住院精神病人社会功能评定量表(SSPI)、简易精神状态检查表(MMSE)得分和残疾等级评定的差异均无统计学意义(均P>0.05)。治疗4周后，与对照组相比，治疗组的BPRS得分及残疾等级评定显著降低，差异具有统计学意义(均P<0.01)；治疗组和对照组治疗后BPRS、SSPI和MMSE得分均显著降低(均P<0.01)，而仅治疗组患者的残疾等级评定显著降低(P<0.01)，对照组患者的残疾等级评定在治疗前后无显著性变化(P>0.05)。结论：CBT能在一定程度上改善残疾精神障碍患者的精神症状及残疾等级，有助于残疾精神障碍患者的康复治疗。

Objective:To investigate the effect of combined cognitive behavioral therapy(CBT) on patients with mental disability.Methods:A total of 80 patients who were strictly assessed as mental disability were included in this study and randomly divided into the control group(conventional treatment) and the treatmentgroup(conventional treatment+intensive CBT treatment), 40 patients in each group. Then, the improvements of mental symptoms, cognitive function, social function, and disability of patients in the two groups were observed after 4 weeks of treatments.Results:There were no significant differences in the scores of brief psychiatric rating scale(BPRS), scale of social function in psychosis inpatients(SSPI), and mini-mental state examination(MMSE) as well as the disability grade between the 2 groups at baseline(all P>0.05). BPRS scores and disability grade of patients in the CBT group were significantly decreased than those in the control group(all P<0.01) and BPRS, SSPI as well as MMSE scores of both CBT and control groups were significantly decreased(all P<0.01) after 4 weeks of treatment. However, only the disability grade of patients in the CBT group was significantly decreased after treatment(P<0.01), while the patients' in the control group had no significant changes(P>0.05).Conclusion:CBT can improve the mental symptoms and disability grade of patients to a certain extent, which is helpful for the rehabilitation of patients with mental disability.

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