精神医学63巻3号

2021年03月発行

特集 サイコーシスとは何か—概念，病態生理，診断・治療における意義

サイコーシスの認知行動療法の動向

著者： 菊池安希子¹

所属機関： ¹国立精神・神経医療研究センター精神保健研究所地域・司法精神医療研究部

ページ範囲：P.387 - P.393

抄録　サイコーシスの認知行動療法(cognitive behavioural therapy for psychosis：CBTp)は，統合失調症治療ガイドラインで推奨される心理的介入である。1990年代より陽性症状に対する効果を示す無作為割付比較試験が重ねられ，標的症状やアプローチ法も広がってきた。複数のメタ分析研究によって，陽性症状に対して中等度の効果量があることが示されている。従来型CBTpでは患者の主訴と治療効果のアウトカムはずれるために効果量の向上が困難であった。CBTpは推奨されているにもかかわらず普及が進んでいないため，各種の取り組みが行われている。日本への導入も1990年代から行われていたが，普及が課題である。

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