A Double-Blind Randomized Controlled Trial of Oxytocin Nasal Spray and Social Cognition Training for Young People With Early Psychosis
A Double-Blind Randomized Controlled Trial of Oxytocin Nasal Spray and Social Cognition Training for Young People With Early Psychosis
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DOI：
10.1093/schbul/sbu094
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发表时间：
2015-03-01
影响因子：
6.6
通讯作者：
Guastella, Adam J.
中科院分区：
文献类型：
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作者：
Cacciotti-Saija, Cristina;Langdon, Robyn;Guastella, Adam J.
社会认知缺陷导致早期精神病的功能结局不佳;然而，对于这些问题，没有有效的药物治疗方法。这项研究是第一个调查催产素鼻喷雾剂与社会认知训练（SCT）相结合的扩展治疗，以改善早期精神病的社会认知，临床症状和社会功能的疗效。在一项双盲、随机、安慰剂对照、受试者间试验中，招募了52名被诊断为早期精神分裂症谱系疾病的个体（年龄16-35岁）。参与者接受催产素（24国际单位）或安慰剂鼻喷雾剂，每天两次，持续6周，并结合SCT组（每周2次，每次1小时，持续6周）。在每周一次的会议之前，给予额外剂量的催产素。在基线、治疗后和3个月随访时进行评估。主要结果包括阅读眼睛中的思想测试、阳性和阴性症状评估量表和社会功能量表。次要结果包括自我报告和社会认知、症状严重程度和社会功能的行为评估。结果显示，在所有主要和次要结局方面，催产素鼻喷雾剂治疗与安慰剂相比没有任何益处。然而，探索性事后分析表明，鼻喷雾剂的使用增加仅与催产素条件下阴性症状的减少相关。这项研究代表了催产素治疗早期精神病的第一次评估。虽然结果表明催产素治疗没有益处，但结果也强调迫切需要考虑鼻喷雾剂递送和未来临床试验的剂量相关变量。
Social-cognitive deficits contribute to poor functional outcomes in early psychosis; however, no effective pharmacological treatments exist for these problems. This study was the first to investigate the efficacy of an extended treatment of oxytocin nasal spray combined with social cognition training (SCT) to improve social cognition, clinical symptoms, and social functioning in early psychosis. In a double-blind, randomized, placebo-controlled, between-subjects trial, 52 individuals (aged 16-35 years) diagnosed with an early psychosis schizophrenia-spectrum illness were recruited. Participants received oxytocin (24 International Units) or placebo nasal spray twice-daily for 6 weeks, combined with group SCT (2 x 1 hour weekly sessions for 6 weeks). An additional dose of oxytocin was administered before each weekly session. Assessments were conducted at baseline, post-treatment, and at 3-month follow-up. Primary outcomes included the Reading the Mind in the Eyes Test, the Scale for the Assessment of Positive and Negative Symptoms, and the Social Functioning Scale. Secondary outcomes included self-report and behavioral assessments of social cognition, symptom severity, and social functioning. Results showed that on all primary and secondary outcomes, there was no benefit of oxytocin nasal spray treatment in comparison to placebo. Exploratory post hoc analysis suggested that increased use of nasal spray was, however, associated with reductions in negative symptoms in the oxytocin condition only. This study represents the first evaluation of oxytocin treatment for early psychosis. Although results suggest no benefit of oxytocin treatment, results also highlight an urgent need to consider nasal spray delivery and dose-related variables for future clinical trials.