Curative effect of olanzapine combined with computerized cognitive remediation therapy in schizophrenia

doi:10.3969/j.issn.1004-583X.2025.12.008

Abstract

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

CLC Number:

R749.3

Ma Xiaoliang, Wang Kaiting. Curative effect of olanzapine combined with computerized cognitive remediation therapy in schizophrenia[J]. Clinical Focus, 2025, 40(12): 1098-1103.

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URL: https://www.lchc.cn/EN/10.3969/j.issn.1004-583X.2025.12.008

https://www.lchc.cn/EN/Y2025/V40/I12/1098

Figures/Tables 6

References 19

[1]	Takeda T, Umehara H, Matsumoto Y, et al. Schizophrenia and cognitive dysfunction[J]. J Med Invest, 2024, 71(3-4):205-209.doi: 10.2152/jmi.71.205.
[2]	Zhou DY, Su X, Wu Y, et al. Decreased CNNM2 expression in prefrontal cortex affects sensorimotor gating function, cognition, dendritic spine morphogenesis and risk of schizophrenia[J]. Neuropsychopharmacology, 2024, 49(2):433-442. doi: 10.1038/s41386-023-01732-y.
[3]	王政, 邵宝富, 王超. 奥氮平治疗精神分裂症患者DTI研究[J]. 医学影像学杂志, 2022, 32(10):1658-1661. doi:10.20258/j.cnki.1006-9011.2022.10.002.
[4]	贾晓妮, 高艺, 陈建波, 等. 奥氮平治疗精神分裂症的临床疗效及影响因素分析[J]. 安徽医药, 2021, 25(11):2317-2320.
[5]	Klojˇcnik M, Bakracevic K. The effectiveness of computerized cognitive remediation therapy (CCRT) for deficits in attention and executive functions in depression: A pilot study[J]. Appl Neuropsychol Adult, 2023, 30(3):306-314.doi: 10.1080/23279095.2021.1941965.
[6]	Strawbridge R, Tsapekos D, Hodsoll J, et al. Cognitive remediation therapy for patients with bipolar disorder: A randomised proof-of-concept trial[J]. Bipolar Disord, 2021, 23(2):196-208. doi: 10.1111/bdi.12968.
[7]	Hirsch JA, Leslie-Mazwi TM, Nicola GN, et al. The ICD-10 system: A gift that keeps on taking[J]. J Neurointerv Surg, 2015, 7(8):619-622.doi: 10.1136/neurintsurg-2014-011321. pmid: 24951285
[8]	司天梅, 杨建中, 舒良, 等. 阳性和阴性症状量表(PANSS, 中文版)的信、效度研究[J]. 中国心理卫生杂志, 2004, 18(1):45-47.
[9]	张玉丹. C-BCT评估稳定期精神分裂症患者认知功能及相关因素[D]. 大连: 大连医科大学, 2022.
[10]	司天梅, 张卫华, 党卫民, 等. 个体和社会功能量表中文版在精神分裂症患者中的信效度[J]. 中国心理卫生杂志, 2009, 23(11):790-794.
[11]	Zhang P, Chen L, Qin Q, et al. Enhanced computerized cognitive remediation therapy improved cognitive function, negative symptoms, and GDNF in male long-term inpatients with schizophrenia[J]. Front Psychiatry, 2025, 16(15):1477285. doi: 10.3389/fpsyt.2024.1477285.
[12]	赵勇, 房传龙, 李皖生. 计算机认知矫正治疗对男性精神分裂症患者认知功能的影响-基于C-BCT的评估[J]. 国际精神病学杂志, 2024, 51(3):709-711+715. doi:10.13479/j.cnki.jip.2024.03.051.
[13]	仲捷, 朱虹, 郝军, 等. 心理理论能力在稳定期精神分裂症精神症状与社会功能之间的中介作用[J]. 首都医科大学学报, 2023, 44(4):590-595.
[14]	Hu JJ, Sun XR, Ni SM, et al. Computerized cognitive remediation therapy on cognitive impairment and social function in patients with chronic schizophrenia[J]. World J Psychiatry, 2024, 14(6):884-893.doi: 10.5498/wjp.v14.i6.884.
[15]	徐林颖, 吴叶红, 李岩峰, 等. 吡拉西坦结合大骨瓣开颅手术治疗对重度颅脑损伤患者血清S100B、NSE水平的影响[J]. 中华神经外科疾病研究杂志, 2025, 19(2):88-91.
[16]	刘化飞, 唐松林. 奥拉西坦联合倍他司汀对卒中后眩晕患者炎症因子及神经功能的影响[J]. 脑与神经疾病杂志, 2023, 31(1):48-52.
[17]	黄俊东, 于林, 朱志敏. 加味逍遥散联合奥氮平对精神分裂症患者认知功能、内分泌激素和神经功能的影响[J]. 世界中医药, 2018, 13(10):2429-2432.
[18]	武鸯, 曹雍华, 张毅. 奥氮平联合无抽搐电休克治疗首发精神分裂症的疗效及对血清炎症因子及BDNF、S100B、GFAP水平的影响[J]. 临床和实验医学杂志, 2021, 20(17):1891-1894.
[19]	薛峰, 贾丽, 胡亚丽. CCRT分别联合奥氮平、利培酮治疗对精神分裂症患者阴性症状和内分泌激素的影响[J]. 中国医学工程, 2022, 30(10):93-96. doi:10.19338/j.issn.1672-2019.2022.10.018.

组别	例数	性别（男/女）	年龄（岁）	受教育年限（年）
观察组	58	38/20	39.57±8.25	12.14±1.12
对照组	58	32/26	38.96±7.37	12.57±1.36
t/χ²值		1.297	0.420	1.859
P值		0.255	0.675	0.066

组别	例数	性别（男/女）	年龄（岁）	受教育年限（年）
观察组	58	38/20	39.57±8.25	12.14±1.12
对照组	58	32/26	38.96±7.37	12.57±1.36
t/χ²值		1.297	0.420	1.859
P值		0.255	0.675	0.066

指标		观察组（n=58）	对照组（n=58）
PANSS
阴性症状	治疗前	22.74±2.69	22.81±2.85
	治疗4周后	18.53±2.41^*#	20.79±2.64^*
	治疗8周后	15.62±2.57^*#	18.95±2.73^*
	治疗12周后	13.32±2.71^*#	14.85±2.53^*
阳性症状	治疗前	19.48±3.14	19.59±2.95
	治疗4周后	15.27±2.86^*#	17.64±2.71^*
	治疗8周后	11.85±2.63^*#	14.92±2.58^*
	治疗12周后	8.64±1.97^*#	9.63±2.46^*
一般精神病理学症状	治疗前	42.52±7.14	42.85±6.57
	治疗4周后	35.16±6.82^*#	39.72±6.43^*
	治疗8周后	28.93±6.15^*#	33.58±6.27^*
	治疗12周后	22.71±5.49^*#	25.37±4.91^*
总分	治疗前	84.74±11.25	85.25±11.24
	治疗4周后	68.96±9.53^*#	76.05±10.12^*
	治疗8周后	56.42±8.71^*#	67.77±9.34^*
	治疗12周后	44.67±6.93^*#	49.85±7.43^*
C-BCT
连线测试	治疗前	39.53±9.63	39.28±10.06
	治疗4周后	41.27±9.08^*#	39.52±8.73
	治疗8周后	42.12±8.13^*#	39.64±8.51
	治疗12周后	43.11±9.24^*#	39.71±8.14
符号编码	治疗前	39.57±11.71	37.25±7.47
	治疗4周后	40.12±10.95	37.68±7.12
	治疗8周后	40.75±10.63	38.21±6.85
	治疗12周后	41.11±10.84	38.76±5.92
持续操作	治疗前	37.45±12.47	37.51±11.37
	治疗4周后	40.13±11.25^*#	36.82±10.84
	治疗8周后	41.86±10.92^*#	35.97±10.53
	治疗12周后	42.98±10.37^*#	35.69±10.71
数字广度	治疗前	40.71±10.84	39.58±9.69
	治疗4周后	40.95±10.72	39.82±9.57
	治疗8周后	41.13±10.68	40.05±9.43
	治疗12周后	41.27±10.63	40.37±8.73

指标		观察组（n=58）	对照组（n=58）
PANSS
阴性症状	治疗前	22.74±2.69	22.81±2.85
	治疗4周后	18.53±2.41^*#	20.79±2.64^*
	治疗8周后	15.62±2.57^*#	18.95±2.73^*
	治疗12周后	13.32±2.71^*#	14.85±2.53^*
阳性症状	治疗前	19.48±3.14	19.59±2.95
	治疗4周后	15.27±2.86^*#	17.64±2.71^*
	治疗8周后	11.85±2.63^*#	14.92±2.58^*
	治疗12周后	8.64±1.97^*#	9.63±2.46^*
一般精神病理学症状	治疗前	42.52±7.14	42.85±6.57
	治疗4周后	35.16±6.82^*#	39.72±6.43^*
	治疗8周后	28.93±6.15^*#	33.58±6.27^*
	治疗12周后	22.71±5.49^*#	25.37±4.91^*
总分	治疗前	84.74±11.25	85.25±11.24
	治疗4周后	68.96±9.53^*#	76.05±10.12^*
	治疗8周后	56.42±8.71^*#	67.77±9.34^*
	治疗12周后	44.67±6.93^*#	49.85±7.43^*
C-BCT
连线测试	治疗前	39.53±9.63	39.28±10.06
	治疗4周后	41.27±9.08^*#	39.52±8.73
	治疗8周后	42.12±8.13^*#	39.64±8.51
	治疗12周后	43.11±9.24^*#	39.71±8.14
符号编码	治疗前	39.57±11.71	37.25±7.47
	治疗4周后	40.12±10.95	37.68±7.12
	治疗8周后	40.75±10.63	38.21±6.85
	治疗12周后	41.11±10.84	38.76±5.92
持续操作	治疗前	37.45±12.47	37.51±11.37
	治疗4周后	40.13±11.25^*#	36.82±10.84
	治疗8周后	41.86±10.92^*#	35.97±10.53
	治疗12周后	42.98±10.37^*#	35.69±10.71
数字广度	治疗前	40.71±10.84	39.58±9.69
	治疗4周后	40.95±10.72	39.82±9.57
	治疗8周后	41.13±10.68	40.05±9.43
	治疗12周后	41.27±10.63	40.37±8.73

指标		观察组（n=58）	对照组（n=58）
PSP	治疗前	33.14±2.95	32.97±3.13
	治疗4周后	41.52±3.67^*#	36.28±3.45^*
	治疗8周后	49.87±4.23^*#	40.15±3.89^*
	治疗12周后	56.84±6.37^*#	43.96±5.12^*
SDSS	治疗前	6.85±1.26	6.63±1.39
	治疗4周后	5.62±1.03^*#	6.15±1.12^*
	治疗8周后	4.47±0.85^*#	5.53±1.01^*
	治疗12周后	3.52±0.36^*#	4.71±0.97^*