集体心理治疗改善早发性精神分裂症患者心理推理能力损伤的效果

摘要

目的:探讨集体心理治疗对早发性精神分裂症患者心理推理能力损伤的改善效果.方法:选取就诊于安徽省精神卫生中心住院的符合疾病和有关健康问题的国际统计分类第十次修订本(ICD-10)诊断标准的精神分裂症患者60例,分为集体治疗组(n＝30)和健康教育组(n＝30).对集体治疗组每周2次,每次2h,共10次集体心理治疗;健康教育组每周2次集体健康教育.采用眼区情绪识别任务和心理推理能力故事图片任务对所有被试进行基线和5周后测评,比较治疗前后心理推理能力的变化.结果:集体治疗组在干预结束时脱落7人,健康教育组在5周后测评时脱落1人.有效数据集体治疗组23人,健康教育组29人.5周后测评时集体治疗组眼区情绪识别测试的总分、悲、恐的眼区情绪辨别以及心理推理能力图片故事任务测试的总分、理解初级错误信念、次级错误信念、三级错误信念、现实感、个人对欺骗的侦测高于基线(P＜0.05);健康教育组对喜的眼区情绪辨别及理解初级错误信念、三级错误信念和总分高于基线(P＜0.05).治疗后集体治疗组TOM-PST的总分、理解次级错误信念、理解三级错误信念得分高于健康教育组(P＜0.05).结论:集体心理治疗可以部分改善早发性精神分裂症患者的心理推理能力,促进其社会认知功能康复.%Objective:To explore the effect of group psychotherapy on damage of theory of mind (TOM) in patients with early-onset schizophrenia.Methods:Totally 60 patients with early-onset schizophrenia were included and divided into the intervention group (n ＝ 30) and the health education group (n ＝ 30).The patients in the intervention group were offered 10 twice a week 2-hour sessions of group psychotherapy,and those in the control were offered group health education twice a week.All participants completed baseline measures and post-intervention measures with the Eye Emotion Recognition and Theory of mind Picture-sequencing Task (TOM-PST).Results:Totally 23 patients in the intervention group and 29 patients in the health education group finished the post-intervention measures.After 5-week intervention,subscores of sad and fear and total score of emotion recognition,total score of TOM-PST,understanding first order error belief,second order error belief,third order error belief,sense of reality,detecting fraud compared to baseline had statistically significant difference in intervention group.In health education group,subscores of joy emotion recognition,understanding first order error belief,third order error belief,total score of TOM-PST compared to baseline had statstically significant difference.The patients with group psychotherapy got higher scores of total score of TOM-PST and understanding second order error belief and third order error belief than the health education group after 5-week intervention (P ＜ 0.05).Conclusion:This study suggests the group psychotherapy could partially improve theory of mind with early-onset schizophrenia,and promote the recovery of social cognition.