Positive Emotions Program for Schizophrenia (PEPS): a pilot intervention to reduce anhedonia and apathy.
Positive Emotions Program for Schizophrenia (PEPS): a pilot intervention to reduce anhedonia and apathy.
复制标题
DOI：
10.1186/s12888-015-0610-y
复制
发表时间：
2015-09-29
期刊：
影响因子：
4.4
通讯作者：
Bonsack C
中科院分区：
文献类型：
--
作者：
Favrod J;Nguyen A;Fankhauser C;Ismailaj A;Hasler JD;Ringuet A;Rexhaj S;Bonsack C
最近的文献已经将与体验能力减弱(冷漠、快感缺乏)相关的负面症状与与表达能力有限(情感迟钝、冷漠)相关的症状区分开来。与表情减少相关的症状相比，冷漠-快感缺乏综合征往往与较差的预后有关。以药物为基础的治疗和心理干预对精神分裂症这些症状的疗效仍然有限。临床上显然需要新的治疗方法。这项初步研究测试了一项减少精神分裂症患者快感缺失和冷漠的计划的可行性，并评估了其对37名符合ICD-10精神分裂症或分裂情感障碍标准的参与者的影响。参与者使用阴性症状量表(SANS)和卡尔加里精神分裂症抑郁量表(CDSS)进行前后测试。他们参加了精神分裂症积极情绪计划(PEPS)的八个疗程-这是一种干预措施，教参与者帮助克服失败主义思维的技能，并增加对积极情绪的预期和维持。31名参与者完成了计划；那些退出的人与完成计划的人没有什么不同。在参与该计划的同时，SANS上的Aleolation-冷漠和Anhedonia-ASocial的总分在统计学上显著下降，效果适中。此外，CDSS的抑郁程度在统计学上有显著的降低，影响幅度很大。在干预期间，情绪迟钝和冷漠保持稳定。研究结果表明，PEPS既是一种可行的干预措施，也与明显特定地减少快感缺乏和冷漠有关。然而，这些发现受限于对照组的缺席和评分者没有忽视治疗目标的事实。PEPS是一种有希望的干预措施，可以改善快感缺乏和冷漠，这需要在一项对照研究中进一步测试。ISRCTN注册机构ISRCTN74048461,2015年5月18日注册
Recent literature has distinguished the negative symptoms associated with a diminished capacity to experience (apathy, anhedonia) from symptoms associated with a limited capacity for expression (emotional blunting, alogia). The apathy-anhedonia syndrome tends to be associated with a poorer prognosis than the symptoms related to diminished expression. The efficacy of drug-based treatments and psychological interventions for these symptoms in schizophrenia remains limited. There is a clear clinical need for new treatments. This pilot study tested the feasibility of a program to reduce anhedonia and apathy in schizophrenia and assessed its impact on 37 participants meeting the ICD-10 criteria for schizophrenia or schizoaffective disorders. Participants were pre- and post-tested using the Scale for the Assessment of Negative Symptoms (SANS) and the Calgary Depression Scale for Schizophrenia (CDSS). They took part in eight sessions of the Positive Emotions Program for Schizophrenia (PEPS)—an intervention that teaches participants skills to help overcome defeatist thinking and to increase the anticipation and maintenance of positive emotions. Thirty-one participants completed the program; those who dropped out did not differ from completers. Participation in the program was accompanied by statistically significant reductions in the total scores for Avolition-Apathy and Anhedonia-Asociality on the SANS, with moderate effect sizes. Furthermore, there was a statistically significant reduction of depression on the CDSS, with a large effect size. Emotional blunting and alogia remain stable during the intervention. Findings indicate that PEPS is both a feasible intervention and is associated with an apparently specific reduction of anhedonia and apathy. However, these findings are limited by the absence of control group and the fact that the rater was not blind to the treatment objectives. PEPS is a promising intervention to improve anhedonia and apathy which need to be tested further in a controlled study. ISRCTN registry ISRCTN74048461, registered 18 may 2015