| Objective:Schizophrenia is a chronic recurrent, persistent disease, it has the characteristics of the high recurrence in patients with serious injuries to the social function and ability to work, now, the majority treatment method of schizophrenia is drug treatment. Use of a number of psychosocial Therapies as additional methods to treat the patient is particularly important, it can improve some symptoms of the patient, especially in the negative emotion and partly negative synptoms. Studies have shown that the Naikan recognitive therapy can improve the recovery of clinical symptoms of schizophrenia, but the naikan cognitive therapy enclouded a course of 7 days, during these days, the patient need to be treated in a closed, quiet and comfortable environment.Because the environment and the time requirements more stringent, not all patients can not persisted in this time. The Discontiguous Naikan Cognitive Therapy(DNCT) not require the restrict time and environment as same as the Naikan recognitive therapy, it maybe moer suitable to the patient. Now, we use the DNCT to treat the patients who at the recovery status of paranoid schizophrenia, to evaluate the effect of this.Methods:Patients who meet the inclusion criteria and exclusion criteria of schizophrenia, from June 2009 to December, totally, there are 100 patients were selected into the study. The study participants all in line with the International Classification of Diseases, Tenth Edition (ICD-10) and the Chinese Classification and Diagnostic Criteria of Mental Disorders Third Edition (CCMD-3) diagnostic criteria for paranoid schizophrenia, one or more episodes; currently in the status of clinical recovery, PANSS score=60, male and aged 16-40 years old, junior high school or above. The informed consent was signed by the supervisor of every patient. Patients were divided into the discontiguous naikan cognitive therapy group(study group), and controls group, randomly. Study group taking the drug accompanied by the DNCT lasted four weeks,3 hours per day. The control group was given medication for four weeks. The positive and negative syndrome scale (PANSS), brief psychiatric rating scale (BPRS), symptom checklist (SCL-90), nurses observation scale (NOSIE) assessment were used to evaluate the effects of the therapy when before treatment and after treatment and twelve weeks.Results:40 cases of the final study group and control group 49 patients were encluded into the final analysis,11 patients draw out. Before treatment, there are no significant difference between the study group and the control group by all the assessment tools.①After treatment, in the study group,PANSS the positive symptom item, negative symptoms item, general psychopathology item, the lack of response factor, thought disorder factor, paranoid ideation, and depression factor of PANSS scored lower than before, The difference was statistically significant (t=2.321 5.430, P<0.05), the control group before and after treatment in the PANSS positive symptom scale item and paranoid ideation item scores were decreased significantly (t =2.191～2.412, P<0.05) and the depression factor scores were increased, the difference was statistically significant (t=-2.215, P=0.032), PANSS study group after treatment, total scores, negative symptom item score, composite itemscore, the general psychopathology item, the lack of response to the scores, depression, thinking disturbance factors score significantly lower than the control group (t=-3.876, P= 0.000; t=-3.789, P=0.000; t=-2.251, P=0.027; t=-3.306, P=0.001; t=-2.128, P =0.036; t=-2.462, P=0.016; t=-3.865, P=0.000). After twelve weeks follow-up study, in the study group, PANSS total scores, item score of positive symptoms, negative symptoms item score, general psychopathology item, the lack of response factor, thought disorder factor, paranoid ideation, and depression factor score was still significantly lower than before treatment, the difference was statistically significant (t =2.061-4.764, P<0.05), After twelve weeks follow-up study, in the study group, PANSS positive symptom item points, the activation of factor scores lower than before treatment, the difference was statistically significant (t=2.255～2.274, P <0.05);②in the study group, BPRS total scores after treatment, anxiety and depression factor, damping factor, thought disorder factor and hostile speculation factor scores were significantly lower than before treatment, the difference was statistically significant (t=2.737～4.234, P<0.05). In control group, before and after treatment, only BPRS retardation factor scale score points lower, the difference was statistically significant (t=2.121, P=0.039), anxiety and depression factor scores were increased significantly (t=-2.258, P=0.029), in the study group after treatment, BPRS total score, anxiety and depression factors, activities, the scores were much lower than the control group (t=-2.616, P=0.010; t=-3.436, P=0.001; t=-3.626, P=0.000). After twelve weeks follow-up, BPRS total score, anxiety and depression factor, inhibit factor, thought disorder factor and hostile speculation factor score was still significantly lower than before treatment, in the study group, the difference was statistically significant (t=2.181～3.583, P<0.05). in the control group, after twelve weeks follow-up, anxiety and depression scored higer than before treatment, the difference was statistically significant (t=-2.088, P=0.042);③In study group patients, the SCL-90 scale Total score, obsessive-compulsive symptoms factor, interpersonal sensitivity factor, depression factor, anxiety, hostility factor, fear factor, paranoid ideation, psychosis factor score was significantly lower than before treatment, the difference was statistically significant (t=2.065～3.701, P<0.05). In the control group, before and after treatment, the SCL-90 scale scores of terrorist factor, psychosis factor scores decreased significantly (t=2.130～2.221, P<0.05), anxiety factor, depression factor scored lower, the difference was statistically significant (t=-2.229～-2.106, P<0.05). In the study group, after treatment, SCL-90 total scores, factor scores of obsessive-compulsive symptoms, depression factor scores, the scores of anxiety, phobic, psychosis factor scores were significantly lower than the control group (t=-3.351, P=0.001; t=-2.983, P=0.004; t=-3.685, P= 0.000; t=-2.891, P=0.005; t=-2.995, P=0.004; t=-2.628, P=0.010), In the study group, after twelve weeks follow-up, SCL-90 total score, interpersonal sensitivity factor, depression factor, anxiety, hostility factor, fear factor, paranoid ideation, psychiatric factor score was still significantly lower than before treatment, the difference was statistically significant (t=2.180～3.172, P<0.05), in control group, SCL-90 scale score lower than the factor of psychosis before treatment, the difference was statistically significant (t=2.493, P=0.016),④In study group, after treatment, NOSIE Scale total negative factors, irritation factor, retardation factor, depression factor scores were significantly lower than before, the difference was significantly (t =2.469～3.138, P<0.05), total positive factors, factors of social competence, social interest factor, the total estimated factor in the disease scores were significantly higher than before treatment, the difference was statistically significant (t=-4.730～-2.199, P<0.05), in the control group, before and after treatment, the irritation factor of NOSIE scale score is lower, the difference was statistically significant (t=2.839, P =0.007), social competence factors, personal cleanliness factor, the total negative factors, depression factor score are increased, the difference was statistically significant (t=-2.273～-2.041, P<0.05), after treatment, in the study group, negative factors, depression factor scores of NOISE were significantly lower than the control group (t=-3.953, P=0.000; t=-4.312, P=0.000), social interest factor, the total estimated factor scores of the disease was significantly higher (t=3.125, P= 0.002; t=3.088, P=0.003), twelve weeks follow-up, study group total negative factors of NOSIE scale, irritation factor, retardation factor, depression factor score was still lower than before treatment, the difference was statistically significant (t= 2.040～2.567, P<0.05), total positive factor, social competence factor and social interest factor, the condition rating of the total estimated factor significantly higher than that before treatment, the difference was statistically significant (t=-3.338～-2.054, P<0.05), twelve weeks follow-up group in the total scale score of NOSIE negative factors factor, social competence factor, personal cleanliness factor scored higher than before treatment, the difference was statistically significant (t=-2.148～-2.072, P<0.05), irritability factor scored lower than before treatment, the difference was significantly (t=4.612, P=0.000).Conclusion:①DNCT can improve the recovery of patients with paranoid schizophrenia symptoms,②DNCT can change the habitual ways of thinking, change the non-rational knowledge, to benefit to the patients response to stress events, to reduce psychological stress, promote mental harmony and reduce the risk of recurrence;③DNCT can assertive the social support and improve the rehabilitation of patients, reduce the negative emotion of the patient who with post-schizophrenia④DNCT as a effective psychological treatment, it is easy to operate, can improve the remissiom of the schizophrenia. |
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