Abstract:

AIM: To investigate the intervention effect of modified Ganmaidazao Tang combined with cognitive behavioral intervention(CBT) on ultra-high risk for developing psychosis and the effects on cognitive function, quality of life and serum levels of 5-HT, MT and TSH. METHODS:A total of 110 patients of first-degree relatives of schizophrenia patients or who met the UHR criteria in our hospital from January 2015 to December 2016 were selected as the study subjects.All subjects were randomly divided into study group (35 cases), control group 1 (35 cases) and control group 2 (40 cases).The study group was given modified Ganmaidazao Tang combined with CBT, the control group 1 was given CBT, the control group 2 did not intervene, only questionnaire follow-up.The scale of prodromal symptoms (SOPS) was used to evaluate the prodromal symptoms,the Continuous perfomance test (CPT) and Wisconsin Card Sorting Test (WCST) was used to evaluate the cognitive function,the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) was used to evaluate the quality of life.Precursor symptoms, mental disease conversion rate, cognitive function, quality of life, and serum 5-HT, MT, and TSH levels were compared at different time points.RESULTS:At the 3th, 6th, 12th, and 18th months, the SOPS positive symptom score, SOPS disintegration symptom score, SOPS general symptom score, and SOPS total score of the study group were significantly lower than those of the control group 1 and the control group 2, the SOPS positive symptom score, the SOPS disintegration symptom score, the SOPS general symptom score, and the SOPS total score of the control group 1 were significantly lower than those of the control group 2 (P<0.05).The conversion rate of mental illness in the study group and the control group 1 was lower than that in the control group 2 at the 6th months, and the conversion rate of mental illness in the study group was lower than that in the control group 2 at the 12th and 18th months (P<0.05).At the 3rd, 6th, 12th, and 18th months, the CPT (reaction time) and WCST (number of persistent errors) in the study group and the control group 1 were lower than those in the control group 2 (P<0.05).At the 3th, 6th, 12th, and 18th months, the Q-LES-Q score of the study group was higher than that of the control group 1 and the control group 2, and the Q-LES-Q score of the control group 1 was higher than that of the control 2 groups (P<0.05);at the 3th, 6th, 12th, and 18th months, the serum 5-HT, MT, and TSH levels of the study group were higher than those of the control group 1 and the control group 2, and at the 3rd, 6th, 12th, and 18th months, the serum MT level of the control group 1 was higher than that of the control group 2, at the 6th, 12th, and 18th months. Serum 5-HT and TSH levels in control group 1 were higher than those in control group 2 (P<0.05).CONCLUSION:Modified Gan Mai Da Zao Tang combined with CBT can effectively improve the positive symptoms, disintegration symptoms, general symptoms and cognitive function of UHR, reduce the conversion rate of mental illness,improve quality of life,and regulate the levels of serum 5-HT, MT and TSH.

Key words: ultra-high risk for developing psychosis, Gan Mai Da Zao Tang, cognitive behavioral intervention, prodromal symptoms, cognitive function, quality of life