社会认知与互动训练对社区精神分裂症患者康复效果的影响
Effect of social cognition and interactive training on rehabilitation of schizophrenic patients in community

目的 · 探讨社会认知与互动训练（social cognition and interactive training， SCIT）对精神分裂症康复的有效性和可行性，拟建立一种新的社区康复模式。方法 · 选取上海市虹口区社区管理的 60 名精神分裂症患者，随机分成对照组和 SCIT 组，每组 30 名。对照组予以常规社区管理，SCIT 组在常规社区管理的基础上予以 SCIT 干预。干预前后用相关量表评估，采用 SPSS 22.0 软件进行方差分析，观察接受 SCIT 干预的患者的康复效果。结果 · SCIT 组执行面部情绪识别任务所用时间较对照组无显著性差异，但正确率明显提高。SCIT 组模糊意向的敌意问卷各评分均显著降低，阳性与阴性症状量表总分及部分分量表分数、阴性症状评定量表总分及分量表分数、卡尔加里精神分裂症抑郁量表评分以及多伦多述情障碍量表评分均显著下降，个人与社会表现量表总分提高。根据患者在训练中的参与情况以及反馈表可以看出，SCIT 有较高的接受度，得到了患者的积极肯定。结论 · SCIT 可以提高社区精神分裂症患者的社会认知和社会功能，对精神症状尤其是阴性症状、抑郁症状也有改善效果，且有较高的可行性和接受度，可在社区康复工作中推广。
： Objective · To explore the effectiveness and feasibility of social cognitive and interactive training (SCIT) in rehabilitation of schizophrenic patients, and propose to establish a new mode of community rehabilitation. Methods · A total of 60 patients with schizophrenia managed in the community in Shanghai Hongkou District were divided into control group and intervention group with 30 cases in each group. The control group was treated with conventional community management. The intervention group accepted SCIT courses at the base of conventional community management. Before and after the intervention, all patients completed the related scales for schizophrenia. Scale scores were analyzed with analysis of variance by SPSS 22.0 to explore the rehabilitation effect of training. Results · In intervention group, the time used in the face emotion identification task (FEIT) had no significant difference with the control group, but the correct rate for FEIT increased significantly. In intervention group, ambiguous intentions hostility questionnaire-ambiguous items (AIHQ-A) scores were significantly lower. The total and sub scale scores of positive and negative syndrome scale (PANSS) and scale for assessment of negative symptoms (SANS), Calgary depression scale for schizophrenia (CDSS) scores were significantly decreased in intervention group. Otherwise, Toronto alexithymia scale (TAS) scores also decreased. Personal and social performance scale (PSP) scores in the SCIT group were increased after training. Finally, according to the training participation and the feedback of the patients, the training had a higher degree of acceptance and positive affirmation. Conclusion · SCIT can improve the social cognition and social function of schizophrenic patients in the community, also improve the mental symptoms, especially the negative symptoms and depressive symptoms, and has high feasibility and acceptability, so it can be promoted in community-based rehabilitation