关键词: 精神分裂症, 奥氮平, 计算机认知矫正, 多维度症状, 社会功能, 神经功能

Abstract:

Objective To evaluate the efficacy of olanzapine combined with computerized cognitive remediation therapy （CCRT） on multidimensional clinical symptoms，social function and neurobiological indicators in patients with schizophrenia. Methods From May 2023 to April 2025，116 inpatients diagnosed with schizophrenia at Zhumadian Second People's Hospital were randomized （n=58 per group） to receive either olanzapine plus conventional cognitive training （control group） or olanzapine plus CCRT （observation group）. Interventions continued for 12 weeks. Outcomes measured at baseline and at weeks 4，8，and 12 included symptom severity （Positive and Negative Syndrome Scale，PANSS），cognitive performance （China Brief Cognitive Test battery，C-BCT），social function （Personal and Social Performance scale，PSP； Social Disability Screening Schedule，SDSS），and serum biomarkers of neural function （S100 calcium-binding protein B [S100B]，neuron specific enolase [NSE]，and brain derived neurotrophic factor [BDNF]）. Pearson correlation was used to assess relationships among outcome measures. Results Compared with the control group，the observation group showed significantly greater reductions in PANSS negative symptoms，positive symptoms，and general psychopathology at weeks 4，8，and 12. On the C-BCT，the observation group achieved higher scores on the line tracking test and sustained operation T-scores （P<0.05）. Social function improved more in the observation group，reflected by higher PSP scores and lower SDSS scores （P<0.05）. Neurobiologically，the observation group exhibited lower serum S100B and NSE levels and higher BDNF levels than control group （P<0.05）. Pairwise correlations among the outcome variables were of moderate magnitude and statistically significant （P<0.05）. Conclusion Adjunctive CCRT combined with olanzapine produces superior improvements in clinical symptoms，cognitive performance，social function，and neurobiological markers compared with olanzapine plus conventional cognitive training in patients with schizophrenia.

Key words: schizophrenia, olanzapine, computerized cognitive remediation therapy, multi-dimensional symptom, social function, nerve function