陈海萍++章秋萍++张丽娜++张蕾

[摘要] 目的 探討计算机认知矫正治疗（CCRT）对提高精神分裂症患者社会功能水平的作用。 方法 收集2015年1～12月杭州市第七人民医院收治的处于康复期的精神分裂症患者100例，按照随机数字表法分为观察组和对照组，每组各50例。观察组患者接受计算机认知矫正治疗，对照组患者参与常规工娱活动，均持续3个月。治疗3个月后，采用阳性与阴性症状量表（PANSS）评估两组患者的病情严重程度；采用威斯康星卡片分类测验（WCST）评估两组患者的认知功能；采用社会功能缺陷筛选量表（SDSS）、个人和社会功能量表（PSP）评价两组患者的社会功能状况。 结果 两组患者的治疗前病情严重程度、认知功能、社会功能评分值差异无统计学意义（P > 0.05）；治疗3个月后，观察组PANSS总分、阳性量表分、阴性量表分、复合量表分均低于对照组（P < 0.05）；观察组WCST完成卡片总数、正确分类卡片数、完成分类数均高于对照组，持续错误数、随机错误数均低于对照组（P < 0.05）；观察组SDSS评分低于对照组（P < 0.05）；观察组PSP评分中社会中有用的活动、个人和社会的关系、自我照料、干扰和攻击行为等分值高于对照组（P < 0.05）。 结论 CCRT治疗可稳固康复期精神分裂症患者病情，在增强认知功能、社会功能方面具有卓越效果。

[关键词] 精神分裂症；计算机认知矫正；社会功能

[中图分类号] R749.3 [文献标识码] A [文章编号] 1673-7210（2017）01（b）-0154-04

Effect of computer cognitive correction on social function in schizophrenia patients

CHEN Haiping1 ZHANG Qiuping2 ZHANG Li′na1 ZHANG Lei1 YU Hongying1 ZHANG Lihua1 LI Lin3

1.The Second Ward of Psychiatric， the Seventh People′s Hospital of Hangzhou City， Zhejiang Province， Hangzhou 310013， China； 2.Department of Nursing， the Seventh People′s Hospital of Hangzhou City， Zhejiang Province， Hangzhou 310013， China； 3. Department of Psychological Rehabilitation， the Seventh People′s Hospital of Hangzhou City， Zhejiang Province， Hangzhou 310013， China

[Abstract] Objective To study the effect of computer cognitive correction on social function in schizophrenia patients. Methods One hundred schizophrenia patients underwent rehabilitation period in the Seventh People′s Hospital of Hangzhou from January to December 2015 were selected and divided into observation group and control group， with 50 cases in each group， according to the random number table. The patients in observation group were treated by computer cognitive therapy and the patients in control group were treated by routine work and entertainment activities， all patients were treated for three months. Three months after treatment， the disease severity was assessed by PANSS， the cognitive function was evacuated by WCST and the social function was evacuated by SDSS and PSP. Results There had no significant difference in the disease severity， cognitive function and social function between two groups before treatment （P > 0.05）. Three months after treatment， the PANSS scores such as total score， positive symptom score， negative subscale scores and composite score in observation group were lower than those in control group （P < 0.05）； the WCST scores such as complete the card number， card number， correct classification number， completed categories in categories in observation group were higher than those in control group， the persistent error number， number of random error in observation group were lower than those in control group （P < 0.05）； the SDSS score in observation group was lower than that in control group， the PSP scores such as social useful activities， personal and social relations， self care， interference and aggressive behavior scores in observation group were higher than those in control group （P < 0.05）. Conclusion CCRT can further stabilize the condition of schizophrenia patients under rehabilitation period， and has excellent effect in enhancing cognitive function and social function.

[Key words] Schizophrenia； Computerized cognitive remediation therapy； Social function

精神分裂症是一类病因未明的重性精神病，临床症状可涉及感知、思维、情感及行为等方面，部分患者在疾病过程中会出现认知功能损害甚至终生精神残疾[1-2]。处于康复期、病情稳定的精神分裂症患者规律服用抗精神病药物可以继续控制疾病，但是在患者认知功能及社会功能逆转方面的作用较小，使患者无法回归社会[3]。目前临床中关于计算机认知矫正治疗（CCRT）治疗精神分裂症的疗效研究较少，本次研究以此为主体初步探索CCRT在精神分裂症中的应用……