摘要

目的 探索认知行为疗法（cognitive behavior therapy,CBT）对首发精神分裂症(first-episode schizophrenia,FES)患者认知灵活性及快感缺失的影响。

方法 纳入2020年1月至2022年12月在云南省精神病医院住院治疗的符合入组标准的FES，按照入组先后顺序将患者分为对照组和联合组，采用认知灵活性问卷（cognitive flexibility inventory,CFI）评估个体的认知灵活性，采用时间性快感体验量表（temporal experience of pleasure scale,TEPS）评定个体的快感缺失情况。2组患者均服用富马酸喹硫平缓释片治疗，联合组在此基础上合并CBT，8周后复测以上指标。采用SPSS分析组内、组间的差异性。

结果 2组患者在治疗前CFI总分及维度分、TEPS总分及维度分均无差异。治疗第8周末，联合组CFI总分及维度分、TEPS总分及维度分均高于对照组，且具有统计学差异（P<0.05）。

结论 CBT能够显著改善首发精神分裂症FES患者的认知灵活性及快感缺失。

关键词：CBT；首发精神分裂症；认知灵活性；快感缺失

ABSTRACT

Objectives To explore the effect of Cognitive Behavioral Therapy (CBT) on cognitive flexibility inventory and anhedoniain patients with first-episode schizophrenia (FES).

Methods Patients with FES who met the enrollment criteria from January 2020 to December 2022 were included as the study subjects. Patients were divided into control group and combination group. Temporal Experience of cognitive flexibility inventory(CFI), and Pleasure Scale(TEPS) were used to assesse their cognitive flexibility and deletion of pleasure.The control group received quetiapine treatment alone, and the combined group combine with CBT at the base of control group. All the above indicators were retest after 8 weeks later. Differences within and between groups were analyzed by SPSS.

Results There was no difference in the total and dimension scores of CFI and TEPS in the 2 groups at baseline. After 8 weeks, the CFI total and dimension scores, the TEPS total score and the controllability dimension score in the combined group were higher than those of the control group, and were statistically different (P<0.05).

Conclusion  s CBT significantly improved cognitive flexibility inventory and anhedonia in patients with first-episode schizophrenia FES.

Key words: CBT; First-episode schizophrenia;cognitive flexibility inventory; anhedonia