CBT联合小剂量利培酮对精神分裂症患者认知功能影响的神经心理学评估

摘要

目的探讨认知行为治疗（ CBT）联合小剂量利培酮对精神分裂症患者认知功能影响的神经心理学评估。方法采用随机数字表法将100例符合《中国精神障碍分类与诊断标准（第3版）》（CCMD-3）精神分裂症诊断标准的患者分为药物治疗组（对照组）与CBT干预组（研究组）各50例，对照组予以利培酮片治疗，研究组予以CBT干预的同时给予对照组药物剂量的1/3治疗，分别于入组时、治疗6个月及随访6个月采用Wisconsin卡片分类测验（ WCST）、听觉注意测验（ AAT）、临床记忆量表（ CMS）进行认知功能的神经心理学评估。结果治疗6个月后及随访6个月除正确反应数外两组的 WCST、AAT、CMS 指标与治疗前比较差异有统计学意义（ P ﹤0.05或0.01）；随访6个月时两组WCST总测验数、AAT测验比较差异有统计学意义（ P﹤0.05）。结论 CBT联合小剂量利培酮对精神分裂症患者认知功能障碍改善的持续性和远期疗效可能优于单用利培酮治疗。%Objective To explore the neuropsychological evaluation on cognitive function of cognitive kehavioral therapy( CBT ) with small dose risperidone in schizophrenia. Methods 100 cases chronic schizophrenic patients were randomly divided into treatment group and control group. Control groups were treated with risperidone. and treatment group was given CBT with 1/3 antipsy=chotic comkined. Neuropsychological evaluation were tested ky Wisconsin Card Sorting Test( WCST),Auditory Attention Test( AAT), Clinical Memory Scale( CMS)kefore treatment,after treatments 6 months and 6 months follows-up. Results The scores of WCST, AAT and CMS were significantly improved after treatment 6 months and 6 months follows-up(P﹤0. 05 or 0. 01),except for the num=ker of correct response. The scores of 6 months follow up in WCST-the total numker of test and AAT showed significant difference ke=tween two groups(P﹤0. 05). Conclusion CBT comkination with small dose of risperidone effection may ke more effective than that of risperidone therapy for cognitive dysfunction patients with schizophrenia in improving sustainakility and long-term.