type:P(論文)

研究論文

Original article

背景：統合失調症患者の就労支援に関心が高まっている．特に認知改善療法（CRT）と他の訓練の併用は有効な支援手段と考えられている．本研究では，社会的認知の改善を目的としたCRT である社会的認知訓練（SCIT）と職業準備訓練（VPT）を組み合わせることで、介入効果を高める効果を検証することを目的とした。研究方法：参加者は統合失調症と診断された患者である．参加者を3 群に分類した．3 群は（1）SCIT ＋ VPT 群，（2）SCIT 群，（3）対照群の3 群に分けられた．（1）（2）ではプログラムを週1回実施した．介入効果は，介入前後，介入終了8 週間後に仕事関連スキル，社会的認知機能，神経認知機能，精神症状により測定された．結果：SCIT+VPT 群の心の理論（ToM）には交互作用が観察された．しかし，SCIT+VPT 群の介入終了8 週間後の測定では，ToM に対する介入効果の継続性は観察されなかった。考察：3 群間の比較からSCIT とVPT を併用することでCRT 介入の効果が高まる可能性が明らかになった。この知見は，CRT と他のリハビリテーションプログラムを組み合わせることでその効果が高まるというこれまでの先行研究を裏付けるものであった．しかし，CRT とVPT を併用する介入の継続的な効果は確認できず，統合失調症患者の社会的認知機能の改善を就労関連スキルに般化する方法の検討が今後の課題といえる．

Background： There is increasing interest in employment support for schizophrenia patients. Combining cognitive remediation training (CRT) with employment support programs is believed to be an especially effective means of assistance. The purpose of this study was to verify whether combining social cognition and interaction training (SCIT) and vocational preparation training (VPT), two kinds of CRT approaches aimed at improving social cognition, could lead to enhanced intervention effects.Methods：Participants were patients diagnosed with schizophrenia. They were divided into three groups: (1) SCIT + VPT, (2) SCIT only, and (3) control, based on measurements taken prior to the intervention. In (1) (2) program were implemented once per week. Intervention effects were measured through work-related skills, social cognitive function, neurocognitive function, and mental symptoms.Results：Interaction was observed in theory of mind (ToM) of SCIT + VPT group．A significant difference in ToM was identified between the SCIT + VPT group and the control group. However, persistent intervention effects on ToM in the SCIT + VPT group were not observed in measurements taken 8 weeks after the intervention ended.Disscussions：Comparisons between the three groups demonstrated that combining SCIT and VPT might increase the efficacy of CRT interventions. This corroborates previous research findings that combining CRT with other rehabilitation programs enhances its efficacy. However, the intervention was not observed to have persistent effects, raising questions about methods to generalize patients’ improved social cognitive function to employment-related skills, which could be a topic for future study.