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计算机认知矫正治疗对精神分裂症超高危人群的 认知功能、症状及转化的影响
秦丽颖张艳梅许俊杰
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目的 探讨计算机认知矫正治疗(CCRT)对精神分裂症超高危(UHR)人群认知、症状及转 化的影响。方法 选择2016 年3 月—2017 年2 月在大连市第七人民医院门诊就诊的超高危个体及精神 分裂症的一级亲属112 例。按照随机数字表分为CCRT组(57 例)和对照组(55 例),分别给予CCRT干预 和健康教育,干预期3个月。采用精神分裂症认知功能成套测验(MCCB)共识版和前驱期症状量表(SOPS) 于基线时、3 个月、12 个月时进行认知功能评定和症状评估;于3、6、12 个月时进行转化评估,比较转化 率。结果 干预后,CCRT组MCCB 评分中信息处理速度、注意/ 警觉性、工作记忆和推理与问题解决能 力4 个维度改善效果明显,干预前后及干预后两组间比较差异均有统计学意义(P < 0.05)。CCRT 组的 SOPS 的阳性症状和瓦解症状较基线时和对照组改善明显,且持续至12 个月(P < 0.05)。两组的转化率 均呈上升趋势,在第3 和6 个月时对照组(12.7%、18.1%)明显高于CCRT 组(5.3%、1.8%),差异有统计学 意义(P < 0.05);第12 个月时,对照组(20.0%)仍高于CCRT 组(12.3%),但差异无统计学意义(P > 0.05)。 结论 对UHR 人群进行CCRT干预可有效改善其认知功能、阳性症状,一定程度上降低转化率,长远疗 效有待进一步验证。
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Effects of computerized cognitive remediation therapy( CCRT) on the cognition function, symptomsand conversion in ultra-high-risk patients of schizophrenia
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Abstract:
Objective To investigate the effects of computerized cognitive remediation therapy (CCRT) on cognition function, symptoms and conversion in ultra-high-risk( UHR) patients of schizophrenia. Methods A total of 112 UHR individuals and first-degree relatives of schizophrenia were selected from the outpatient department of the Seventh People's Hospital of Dalian from March 2016 to February 2017. According to the random number table, the research subjects were divided into CCRT group( 57 cases) and control group (55 cases). The subjects in the two groups were given CCRT intervention and health education respectively from 3 months. The cognitive function assessment and symptom assessment were carried out at baseline, the 3rd, and the 12th month after intervention using MATRICS Consensus Cognitive Battery( MCCB) and the Scale of Prodromal Symptoms( SOPS). The conversion assessments was conducted at the 3rd,6th and 12th months, and the conversion rates were compared. Results After intervention, the four dimensions of information processing speed, attention/alertness, working memory and reasoning and problem-solving ability in the MCCB score of the CCRT group were significantly improved. There were statistical differences between the two groups after intervention, and the differences before and after intervention were statistically significant( P < 0.05). The positive symptoms and disintegration symptoms of SOPS in the CCRT group were significantly improved compared with baseline and control group, and lasted for 12 months( P < 0.05). The conversion rate of both groups showed an upward trend. At the 3rd and 6th month, the control group( 12.7%, 18.1%) was significantly higher than the CCRT group( 5.3%, 1.8%), and the difference was statistically significant( P< 0.05). At the 12th month, the control group( 20.0%) was still higher than the CCRT group( 12.3%), but the difference was not statistically significant( P> 0.05). Conclusions CCRT intervention in UHR patients with schizophrenia can effectively improve their cognitive function, positive symptoms and reduce conversion rate to some extent. The long-term efficacy needs further verification.

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