| Objective: The study aimed to detect the effect of cognitive-behavioral therapy(CBT) on psychiatric symptoms, cognitive function, the personal and social performance, mood, insight, quality of life(QoL) and compliance to drug of residual schizophrenia; aimed to detect the relationship among psychiatric symptoms, cognitive function, the personal and social performance, QoL of residual schizophrenia.Methods: 90 residual schizophrenia patients meeting the entering conditions were randomly divided into two group,45 patients in each group, CBT and Risperidone for CBT group, Risperidone not CBT for DTC group, blind to raters, then general condition questionnaire, The Positive and Negative Syndrome Scale(PANSS), MATRICS Consensus Cognitive Battery(MCCB), Hamilton Depression Rating Scale for Depression (HAMD), Hamilton Anxiety Scale (HAMA), Self-Esteem Scale(SES), the Personal and Social Performance scale(PSP), insight, the Short-Form 36 Health Survey(SF-36), and compliance to drug were assessed before and after CBT.Results: (1) The scores(11.1±4.08) of negative psychiatric symptoms in PANSS after CBT were significantly lower than the scores(14.3±4.23) before CBT in CBT group(P<0.05),while the scores of positive psychiatric symptoms, symptoms of general pathology and total were not(P>0.05);after CBT, the scores (11.1±4.08)of PANSS in CBT group were not significantly lower than the scores(14.8±3.56) in DTC group(P<0.05), while the scores of positive psychiatric symptoms, symptoms of general pathology and total were not(P>0.05).(2)the scores of trail making test(14.02±6.10), coding(23.70±11.08), fluent of meaning(12.02±6.10), continuous performance test(110.2±28.4),and emotional management quiz(5.32±0.98) in MCCB were significantly lower after CBT than before CBT(16.75±6.78,0.25±0.03,31.60±11.23, 171.2±28.98,7.85±1.60) in CBT group(P <0.05); the scores of trail making test, coding,fluent of meaning, continuous performance test and emotional management quiz in MCCB were significantly lower in CBT group than DTC group(14.10±6.80,0.20±0.02,25.5±10.30,144.2±29.6,7.79±1.56) (P<0.05). (3) the scores of HAMD,HAMA and PSP were separately 9.3±3.12,6.9±2.11,54±12.0 after CBT ,and 15.2±5.41,11.2±3.21,35±10.3 before CBT in CBT group, there were significantly different between them(P < 0.05),while the scores of SES and insight(P>0.05); there were significantly different between CBT group and DTC group after CBT for the scores of HAMD,HAMA and PSP(P<0.05), while the scores of SES and insight(P>0.05). (4)there were significantly difference in compliance to drug between before CBT and after CBT in CBT group(P<0.05); there were significantly difference in compliance to drug between CBT group and DTC group after CBT(P>0.05). (5) the scores of Social functions (SF) ,role limitations due to emotional problems(RE) and mental health(MH) in SF-36 were significantly difference between before CBT and after CBT in CBT group(P<0.05); there were significantly difference in SF,RE and MHA between CBT group and DTC group after CBT(P>0.05).(6) The changed scores of trail making test, coding, fluent of meaning, continuous performance test, and emotional management quiz in MCCB were significantly positive related with the changed scores of negative psychiatric symptoms in PANSS between before CBT and after CBT in CBT group (r=0.274～0.361,P<0.05); The changed scores of trail making test, coding, fluent of meaning, continuous performance test, and emotional management quiz in MCCB were significantly negative related with the changed scores of total PSP, SF-36(SF,RE,MH) between before CBT and after CBT in CBT group (r=-0.255～-0.218, P<0.05).Conclusions: (1) CBT can significantly improve negative psychiatric symptoms for patients with residual schizophrenia, and can significantly improve positivee psychiatric symptoms. (2) CBT can effectively improve cognitive function including execution, attention and social cognition for patients with residual schizophrenia. (3) CBT can significantly improve depression and anxiety for patients with residual schizophrenia. (4) CBT can significantly improve compliance to drug, social function and QoL for patients with residual schizophrenia(5)The negative psychiatric symptoms were significantly related with cognitive function for patients with residual schizophrenia, and the same physiological and pathological basis was exited for them.(6)The improved cognitive function for patients with residual schizophrenia can contributed to improved social function and QoL for patients with residual schizophrenia.(7) CBT were effective to patients with residual schizophrenia, and our study can provide foundation and reference for rehabilitation of patients with residual schizophrenia. |
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