ICF框架下精神分裂症患者认知障碍的研究进展
Journal: Basic Medical Theory Research DOI: 10.12238/bmtr.v8i2.18901
Abstract
目的：系统综述ICF框架下精神分裂症认知障碍的病理机制、评估工具及干预策略，构建多维康复体系的理论与实践路径。方法：整合2016-2024年神经影像学、分子遗传学、随机对照试验及卫生经济学研究，采用系统综述与Meta分析方法，纳入127项高质量研究。结果：（1）神经机制：前驱期即存在前额叶-丘脑环路连接密度降低，DNMT3A甲基化水平与工作记忆缺陷负相关；（2）药物干预：氨磺必利显著提升处理速度，GLP-1激动剂使MCCB总分提升；（3）心理社会干预：认知疗法（CT）是针对精神病性症状最有效的心理社会干预措施，社交技能训练与其他心理社会干预措施相比在减少阴性症状方面具有有效性；（4）经济学效益：CAT显著改善患者社区适应能力，提高社区功能，减少住院次数，且成本更低。结论：ICF框架揭示了认知障碍的多维交互机制，未来需融合数字技术，发展文化适应性干预，并通过政策优化实现认知康复服务的普惠覆盖。
Keywords
精神分裂症；认知障碍；ICF框架；神经可塑性；数字疗法
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