Effect Of Social Skill Training On Cognitive Function In Patients With Chronic Schizophrenia

Objective:To explore the effects of social skill training to improve cognitive function in patients with chronic schizophrenia.Methods:The case sequence design was adopted.According to the digital chart method,60 patients meet the diagnostic criteria with chronic schizophrenia were randomly divided into intervention group with social skill training(n=30)and control group without social skill training(n=30)for 16 weeks of intervention.Social skills training training by using multimedia PPT courseware to guide the patients how to use the language communication,interpersonal skills,problem-solving skills self-confidence,help others and seek help for a total of 5 skills.During each training session,the trainer performs the role play in the assumed scenario to demonstrate skills and review.Each patient plays the role one by one in the same scene.The general demographic data of patients according to self-complied questionnaire were collected before intervention.Wisconsin Card Sorting Test(WCST),Interpersonal Perception Task-15(IPT-15),Social Skills Checklist(SSC)and Social Disability Screening Schedule(SDSS)were used to assess cognitive function,the clinical symptoms and social function before and 16 weeks after the follow-up.The difference of social skills,social function and cognitive function between the intervention group and the control group before and after the social skill training was compared with the independent sample t test.Paired samples t test was used to compare the scores of WCST,IPT-15,SSC and SDSS scores before and after training in the intervention group.The difference of SDSS scale between IPT-15 and WCST in the intervention group was analyzed by correlation analysis.Three aspects of data were compared:1.Differences in social skills before and after social skills training between the intervention group and the control group,and 2.difference of social function between two groups before and after training,and 3.difference of cognitive function between the two groups before and after training.Results:1.SSC scale scores comparison between two groups before and after training.Before intervention,there were no statistical differences in the score of SSC between the two groups(t=0.26,P=0.725).The score of SSC(8.23�2.76)after 16 weeks SST intervention were significantly lower than the scores of SSC(13.85�6.47)before treatment in intervention group(t=2.23,P=0.029).16 weeks after intervention,SSC score(8.23�2.76)in intervention group were significantly lower than the scores(12.98�6.28)in control group(t=6.98,P=0.002).2.SDSS score comparison between two groups before and after training.Before intervention,there were no statistical differences in the score of SDSS between the two groups.After intervention,the total scores of SDSS(6.21�1.78)in intervention group were significantly lower than the total scores(8.84�2.55)in control group(P<0.05).The total score of SDSS(6.21�1.78)and the social withdrawal(0.43�0.31),family outside social activities(0.55�0.41),personal life(0.61�0.44)and responsibility and planning score(1.19�0.82)after intervention were significantly lower than the scores of SDSS(8.56�1.92,082�0.69,0.82�0.61,088�0.69,1.22�0.88)before treatment in intervention group(t=4.23,2.88,2.45,2.58,2.48,P=0.002,0.001,0.032,0.015,0.019).while the scores in control group were not(P>0.05).3.WCST score comparison between two groups before and after training.Before intervention,there were no statistical differences in the each factor score of WCST between the two groups(P>0.05).The scores of rails administered(75.2�10.8),preservative errors(24.5�3.5),random errors(31.6�7.5)in WCST were significantly lower after intervention than before intervention(83.6�9.1,29.8�2.4,37.7�4.7)in intervention group.While the correct responses(26.7�4.7)and categories completed score(3.5�1.0)in WCST were higher than before intervention(23.1 �2.5,3.1 �0.7)in intervention group(t=2.93?3.54,P=0.001?0.029).The each factor score of WCST in control group were not(t=1.12?1.81,P=0.072?0.263).16 weeks after intervention,the scores of correct responses and categories completed(26.7�4.7,3.5� 1.0)in intervention group were significantly higher than the scores(21.9�2.8,3.1 � 1.3)in control group(P<0.05).The scores of rails administered,preservative errors and random errors(75.2� 10.8,24.5�3.5,31.6�7.5)in intervention group were significantly lower than the scores(80.6� 11.4,27.3�3.0,37.0�6.5)in control group(P<0.05).4.IPT-15 data comparison between two groups before and after training.There were no statistical differences in the each factor score of IPT-15 between the two groups before intervention(t=0.11?1.33,P=0.179?0.873).After intervention,the kinship factor(2.15�0.39),competition factor(2.29�0.61).total scores(9.98�1.52)of IPT-15 in intervention group were all significantly higher than those in control group(1.85�0.74,1.91 �0.83,8.68�0.69)(t=2.07,2.01,2.08,P=0.041,0.045,0.039).The total score of IPT-15(9.98�1.52),the kinship(2.15�0.39)and competition score(2.29�0.61)after intervention were significantly higher than the scores of IPT-15(8.65� 1.05,1.82�0.78,1.75�0.76)before treatment in intervention group(P<0.05),while the scores in control group were not(P>0.05).5.Correlation between the difference of SDSS scale and the total score of IPT-15 and the difference of WCST in the Intervention group before and after training.The changed scores of SDSS were significantly positive related with the changed scores of the total score in IPT-15 and rails administered(r=0.501,0.487,P=0.016,0.038)in WCST between before and after intervention in intervention group.The changed scores of SDSS were significantly positive related with the changed scores of preservative errors(r=-0.496,P=0.034)in WCST between before and after intervention in intervention group.Conclusion:Schizophrenia patients have cognitive impairment.It is effective for social skill training to improve social cognitive and neurocognitive function in the patients with chronic schizophrenia.Social skills training can effectively improve the social skill and social functions of chronic schizophrenics.Cognitive function changes are associated with changes in social functioning in patients with chronic schizophrenia.