長期入院中の統合失調症患者の職業療法にメタコグニティブトレーニングを追加する効果: 試験的なランダム化制御試験
Rumi Sunohara1,2, Shohei Ichikawa2, Daiki Saito2
1Department of Health Sciences, Graduate School of Medicine, Shinshu University, Nagano, JPN.
Cureus
|August 25, 2025
まとめ
長期にわたって入院している統合失調症患者の場合,職業療法 (OT) と組み合わせたメタコグニティブトレーニング (MCT) は実現可能であり,特に高齢者の場合,精神疾患の症状を改善する可能性がある. 認知機能は有意な改善を示さなかった.
科学分野:
- 精神科
- 認知神経科学
- ゲロントロジー
背景:
- 統合失調症は慢性的な精神疾患で しばしば長期の入院が必要になります
- 統合失調症の長期入院患者は 精神疾患の症状や認知機能の欠陥を 頻繁に経験します
- メタコグニティブトレーニング (MCT) は,認知および感情の調節を改善することを目的とした治療アプローチです.
研究 の 目的:
- 長期にわたる統合失調症患者の精神症状と認知機能に対する,職業療法 (OT) と組み合わせたメタコグニティブトレーニング (MCT) の効果を調査する.
- 慢性統合失調症患者の高齢者におけるMCTの実現可能性と潜在的利点を評価する.
- 認知機能や治療への反応に 年齢が及ぼす影響について調べる
主な方法:
- 日本における統合失調症の長期入院患者を対象としたランダム化制御試験.
- 参加者は,作業療法 (OT) と16週間のMCTセッション,または4ヶ月間単独のOTに割り当てられました.
- 認知機能 (MoCA- J),精神症状 (PANSS),認知洞察力 (BCIS),全体的な機能 (GAF) が介入前および介入後評価されました.
主要な成果:
- 両グループは認知機能 (MoCA- J) の向上傾向を示し,グループ間の有意な差異はなかった.
- 年齢とMoCA- Jスコアとの間の負の相関が観察されました.
- OT+MCTグループは,OT単独と比較して,特に高齢者 (≥68歳) で,ネガティブな症状,一般的な精神病理,および総PANSSスコアにおいて有意な改善を示した.
結論:
- メタコグニティブトレーニング (MCT) は,長期入院した老年統合失調症患者の場合,作業療法 (OT) と組み合わせて実行可能である.
- OT+MCTは,認知機能が有意に改善しなかったが,老年患者の持続的な精神症状の管理に特に有益である.
- 認知効果,最適な治療パラメータ,および薬物相互作用を調査するためにさらなる研究が必要です.
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