Schizophrenia Disorders, Cognitive Impairment, Acceptance and Commitment Therapy
Conditions
Brief summary
ACT combined with stratified intervention improved cognitive function and quality of life in elderly schizophrenia patients by enhancing psychological flexibility and family support.
Detailed description
This study analyzes factors influencing cognitive impairment and evaluates the efficacy of a stratified intervention combining Acceptance and Commitment Therapy (ACT) with these factors to improve cognitive function and quality of life. A total of 149 elderly patients with schizophrenia were enrolled, split into cognitive impairment (n = 86) and non-cognitive impairment (n = 63) groups. A combined case-control and randomized controlled trial design was employed. Logistic regression was used to identify independent risk factors. Cognitive impairment patients were randomly assigned to either the conventional treatment group (n = 39) or the ACT group (n = 39) for a 6-week intervention. Evaluation instruments included the AAQ-II (psychological flexibility), GSES (self-efficacy), FACES II-CV (family functioning), SSMI-C (internalized stigma), and SQLS (quality of life).
Interventions
Patients received conventional mental health education once weekly for 6 weeks, covering schizophrenia symptoms, treatment, and prognosis. Standard nursing care and antipsychotic medications (e.g., olanzapine, quetiapine) were maintained without additional psychological interventions.
OTHERthe ACT group
Patients received ACT-based nursing interventions tailored to risk factors (e.g., age ≥70, long disease duration), including: ACT modules: Acceptance, cognitive defusion, mindfulness, values clarification, and committed action. Adjunct strategies: Family therapy, Tai Chi, and crisis planning. Frequency: Daily practice + 1-2 group sessions/week for 6 weeks. Goal: Enhance psychological flexibility, reduce stigma, and improve cognitive function.
Sponsors
Third People's Hospital, Huzhou City, Zhejiang Province, China
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* (1)Meets the diagnostic criteria for schizophrenia as defined in the International Classification of Diseases, Tenth Revision (ICD-10); * (2) age \> 60 years; * (3)possesses at least a primary school education, enabling independent completion of all questionnaires; * (4) has been taking antipsychotic medication continuously and regularly for at least one year during the enrollment period, with current symptoms and disease status stabilized in the maintenance phase; * (5)informed consent obtained from the patient or their family/guardian.
Exclusion criteria
* (1) Coexisting organic mental disorders, affective disorders, or similar conditions; * (2) coexisting physical illnesses that may affect cognitive function, such as hepatic or renal dysfunction; * (3) alcohol dependence or dependence on psychoactive substances; * (4) receipt of electroconvulsive therapy within the past three months.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Cognitive Function | Baseline to 6 weeks post-intervention | Improvement in global cognitive function assessed via the Montreal Cognitive Assessment (MoCA), focusing on memory, attention, and executive function. Higher scores indicate better cognition (range: 0-30). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Psychological Flexibility (AAQ-II) | Baseline to 6 weeks. | Scores on the Acceptance and Action Questionnaire-II (7 items, Likert scale 1-7). Lower scores indicate greater flexibility. |
| Self-Efficacy (GSES) | Baseline to 6 weeks. | General Self-Efficacy Scale (10 items, scores 10-40). Higher scores reflect stronger self-efficacy. |
| Family Functioning (FACES II-CV) | Baseline to 6 weeks. | Family Adaptability and Cohesion Evaluation Scale (cohesion + adaptability subscales). Higher scores indicate healthier family dynamics. |
| Stigma Reduction (SSMI-C) | Baseline to 6 weeks. | Stigma Scale for Mental Illness (28 items). Lower scores on Discrimination/Illness Concealment subscales indicate reduced stigma. |
| Quality of Life (SQLS) | Baseline to 6 weeks. | Schizophrenia Quality of Life Scale (30 items). Lower scores indicate better QoL in psychosocial, motivation, and symptom domains. |
Countries
China
Outcome results
None listed