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중장년 만성 조현병 환자에서 인지행동사회기술훈련의 효과 6주, 전향적, 무작위 비교연구 : 예비연구

A Randomized Controlled Pilot Study of Cognitive Behavioral Social Skills Training (Korean version) for Middle- or Older-Aged Patients with Schizophrenia : A Pilot Study

최용성|박한선|이도형|고석만|김건종
대한신경정신의학회 (Korean Neuropsychiatric Association)|2012.07|신경정신의학 (JOURNAL OF THE KOREAN NEUROPSYCHIATRIC ASSOCIATION)|제51권 제4호|pp. 192-201

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참고문헌

키워드

조현병Schizophrenia사회재활인지행동사회재활훈련Social rehabilitationCognitive behavioral social skills training
주제분류정신과학

초록

본 연구는 만성 조현병 환자에서 인지행동사회기술훈련의 효과를 검증하고자 하였다. 연구 결과 인지행동사회기술훈련에 참여한 집단의 환자군이 대조군에 비해서 우울감이호전되었고 전반적 삶의 질과 사회적 관계의 향상을 보여주었다. 정신병원에 입원 중인 만성 조현병 환자들에 대해서인지행동요법과 사회기술 훈련을 병합한 본 치료프로그램의 적용을 통해서 몇 가지 유의한 임상적 이득을 가질 수 있다는 가능성을 보여 주었다. 추후 본 프로그램에 대한 보다다양하고 폭넓은 임상적 적용을 통해서 다양한 환자군에 대한 임상적 증상 개선 및 삶의 질, 사회적 기술의 향상에 대한정교한 확인뿐만 아니라, 그 외의 잠재적인 가능성에 대한추가적인 연구가 필요할 것으로 보인다.

Abstract

Objectives Cognitive behavioral therapy and social skills training have been proposed as a promising modality for treatment of patients with schizophrenia. The objective of this study was to evaluate the effectiveness of Cognitive Behavioral Social Skill Training (CBSST) in patients with chronic schizophrenia. Methods Twenty six middle- or older-aged hospitalized patients with schizophrenia were selected in a mental hospital. Eleven participants were randomly assigned to undergo treatment with CBSST and 15 participants were assigned to receive the usual treatment. CBSST was administered in a single group over 12 sessions for a period of weeks, and the participants were assessed by blinded raters at base line and end point, and end of treatment. Results Compared to patients who received the usual treatment, those who received treatment with CBSST showed a significant reduction of Hamilton Rating Scale for Depression score, however, scores for other psychiatric symptoms did not differ significantly. In terms of Quality of life (QoL) analysis, scores for overall quality of life showed a more significant increase in the CBSST group, compared with the group of patients who received the usual treatment. According to results of the Independent Living Skill Survey, patients receiving CBSST showed significantly greater involvement in social activities than patients receiving usual treatment group. Conclusion Psychosocial intervention for patients with chronic schizophrenia is very important, not only for management of primary psychiatric symptoms, but also for QoL and social rehabilitation. The results of this study, showing improvement of depressive mood, overall life quality, and social activities, suggest that CBSST could be an effective treatment for these patients. This study is a pilot study performed in an inpatient treatment setting. Further studies are required in order to clarify the advantage of CBSST in treatment of patients with chronic schizophrenia, esp. under outpatient settings.

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