Does Biofeedback Improve Symptoms of Schizophrenia (Emotion, Psychotic Symptoms, and Cognitive Function)?

生理回饋可以治療思覺失調症病人之症狀（情緒、精神症狀及認知功能）嗎？

林家如(Chia-Ju Lin) ； 洪一永(Yi-Yung Hung) ； 林敬淳(Chin-Chuen Lin) ； 蔡孟璋(Meng-Chang Tsai) ； 黃條來(Tiao-Lai Huang)

《台灣精神醫學》 30卷2期 (2016/06) Pp. 120-127+iv

摘要

背景：評估生理回饋治療對於改善思覺失調病人的情緒、精神症狀及認知功能的效果。方法：自2012 年至2013 年，共25 位診斷為思覺失調症病人被招募，包括生理回饋組16 位（漸進式肌肉放鬆的個別治療，每週3 次，持續兩週）和控制組9 位。所有病人均接受貝克憂鬱量表- 第二版 (BDI-II)、貝克焦慮量表 (BAI)、症狀檢核量表 (SCL-90R) 和路徑描繪測驗(Trial Making Test, TMT)。結果：結果顯示治療組在BAI (p = 0.05)，SCL-90R 中的depression(p = 0.05)，anxiety (p = 0.05)，paranoid ideation (p ＜ 0.05)，additional items（睡眠障礙與食慾問題）(p ＜ 0.05) 指標均有顯著降低，認知功能部分，TMT A (p = 0.01) 也有顯著降低。對照組則是在TMT A (p = 0.01) 及TMT B (p = 0.01) 均有顯著下降。顯示在兩組間，認知功能沒有顯著差異的改善。結論：生理回饋可以改善思覺失調症病人的憂鬱，焦慮，妄想，睡眠障礙和食慾等臨床症狀。

關鍵字

生理回饋 ； 認知功能 ； 情緒 ； 思覺失調症

並列摘要

Objectives: Patients with schizophrenia tend to experience emotional distressand to have impaired cognitive function. The objective of this study was to investigatethe effect of the biofeedback therapy on patients with schizophrenia. Methods: From December 1, 2012 to November 30, 2013, we recruited in- and outpatientsdiagnosed with schizophrenia. They were randomized into the biofeedbackgroup (treated with individual progressive muscle relaxation therapy [PMRT], three times a week, for two weeks) and the control group. All patients were evaluatedusing Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Symptom Checklist-90-R, and Trial Making Test (TMT). Results: We recruited 25patients, including 16 in the biofeedback group and 9 in the control group. Theresults showed significantly lower BAI scores (p = 0.05), lower depression (p =0.05), lower anxiety (p = 0.05), lower paranoid ideation (p ＜ 0.05), lower additionalitems (sleep disturbances and appetite) (p ＜ 0.05) and lower TMT A (p =0.01) scores in the biofeedback group compared to the control group. TMT A (p =0.01) and TMT B (p = 0.01) were found to be significantly lower in the controlgroup. No statistical significance was found in the cognitive function improvementbetween the two groups. Conclusion: Biofeedback could improve the clinicalsymptoms of depression, anxiety, paranoid ideation, sleep disturbances and appetitein patients with schizophrenia.

並列關鍵字

biofeedback ； cognitive function ； emotion ； schizophrenia

參考文獻

Chien IC, Chou YJ, Lin CH, Bih SH, Chou P, Chang HJ: Prevalence and incidence of schizophrenia among national health insurance enrollees in Taiwan, 1996-2001. Psychiatry Clin Neurosci 2004; 58: 611-8.

Tibbo P, Swainson J, Chue P, LeMelledo JM: Prevalence and relationship to delusions and hallucinations of anxiety disorders in schizophrenia. Depress Anxiety 2003; 17: 65-72.

Lysaker PH, Davis LW, Hunter NL, Nees MA, Wickett A: Personal narratives in schizophrenia: increases in coherence following 5 months of vocational rehabilitation. Psychiatr Rehabil J 2005; 29: 66-8.

Huppert JD, Weiss KA, Lim R, Pratt S, Smith TE: Quality of life in schizophrenia: contributions of anxiety and depression. Schizophr Res 2001; 51: 171-80.

Birchwood M: Early intervention in schizophrenia: theoretical background and clinical strategies. Br J Clin Psychol 1992; 31 (Pt 3): 257-78.