Intervención desde el modelo cognitivo conductual en el trastorno de esquizofrenia: una revisión de avances investigativos
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Fecha
2023
Autores
Fernández Terraza, Kleinys Darid
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Ediciones Universidad Simón Bolívar
Facultad de Ciencias Jurídicas y Sociales
Facultad de Ciencias Jurídicas y Sociales
Resumen
La esquizofrenia es un trastorno de salud mental de origen multifactorial que impacta negativamente en la funcionalidad y la vida diaria de quienes la padecen debido a alteraciones neurocognitivas que se desencadenan por factores psicosociales y genéticos. De acuerdo con la Clasificación Internacional de Enfermedades (CIE-10), los trastornos esquizofrénicos se caracterizan por distorsiones en la percepción y el pensamiento, como percepciones delirantes, robo del pensamiento y alucinaciones auditivas, entre otros. El propósito de esta monografía fue identificar y describir las intervenciones basadas en la terapia cognitivo-conductual (TCC) para el tratamiento psicológico de la esquizofrenia desde el período comprendido entre 2018 y 2023. La investigación se llevó a cabo a través de una búsqueda exhaustiva en la base de datos PubMed, seleccionando estudios que abordaran intervenciones que combinan tratamientos basados en la TCC con enfoques farmacológicos y no farmacológicos en pacientes con esquizofrenia y síntomas prodrómicos. De los (n=38) artículos identificados, se incluyeron (n=26) que cumplían con los criterios de inclusión. Estos estudios evaluaron la eficacia de la combinación de la TCC con antipsicóticos en pacientes con primer episodio psicótico, demostrando la viabilidad y seguridad de esta intervención. Además, se encontró que la TCC puede ser clínicamente efectiva en pacientes jóvenes con un buen funcionamiento, mejorando su desempeño laboral y cognitivo, así como aliviando los síntomas negativos de la esquizofrenia. En cuanto a la prevención de recaídas, la TCC se mostró eficaz en el tratamiento de síntomas positivos, con mejoras sostenidas un año después del tratamiento. Para síntomas como alucinaciones y trastornos del sueño, la TCC demostró eficacia en el control de las voces alucinatorias y en la normalización e integración de la experiencia de estas. Además, una intervención de exposición basada en la TCC mejoró las crisis agudas de insomnio. La combinación de la realidad virtual y la TCC también resultó factible, logrando una reducción de los síntomas paranoides, afectos negativos y alucinaciones. En lo que respecta a los síntomas negativos, la TCC mostró una mayor eficacia en su control y disminución, reduciendo los síntomas depresivos y mejorando la gravedad general del trastorno esquizofrénico, así como el funcionamiento de los pacientes. Estos hallazgos resaltan la necesidad imperante de continuar investigando en el campo de la terapia cognitivo-conductual para la esquizofrenia, ya que ofrecen perspectivas prometedoras para mejorar la calidad de vida de las personas afectadas por este trastorno mental y abren nuevas posibilidades de tratamiento y rehabilitación.
Schizophrenia is a multifactorial mental health condition that adversely affects functionality and daily life in those diagnosed due to neurocognitive disturbances triggered by psychosocial and genetic factors. According to the ICD-10, schizophrenia disorders are characterized by distortions in perception and thinking, such as delusional perceptions, thought withdrawal, and hallucinatory voices, among others. The purpose of this monograph was to identify and describe interventions based on cognitive-behavioral therapy (CBT) for the psychological treatment of schizophrenia from the period between 2018 and 2023. The research was conducted through a comprehensive search in the PubMed database, selecting studies that addressed interventions combining CBT-based treatments with pharmacological and non-pharmacological approaches in patients with schizophrenia and prodromal symptoms. Out of the 38 identified articles, 26 meeting the inclusion criteria were included. These studies evaluated the effectiveness of combining CBT with antipsychotics in patients with a first psychotic episode, demonstrating the feasibility and safety of this intervention. Furthermore, CBT was found to be clinically effective in young patients with good functioning, improving their cognitive and work performance, as well as alleviating negative symptoms of schizophrenia. In terms of relapse prevention, CBT proved effective in treating positive symptoms, with sustained improvements one year after treatment. For symptoms such as hallucinations and sleep disorders, CBT demonstrated efficacy in controlling hallucinatory voices and normalizing and integrating the experience of hearing them. Additionally, an exposure-based CBT intervention improved acute insomnia crises. The combination of virtual reality and CBT also proved feasible, resulting in a reduction of paranoid symptoms, negative affect, and hallucinations. Regarding negative symptoms, CBT showed greater effectiveness in their control and reduction, reducing depressive symptoms and improving the overall severity of schizophrenia, as well as the functioning of patients. These findings underscore the pressing need to continue research in the field of cognitive-behavioral therapy for schizophrenia, as they offer promising perspectives for enhancing the quality of life of individuals affected by this mental disorder and open up new possibilities for treatment and rehabilitation.
Schizophrenia is a multifactorial mental health condition that adversely affects functionality and daily life in those diagnosed due to neurocognitive disturbances triggered by psychosocial and genetic factors. According to the ICD-10, schizophrenia disorders are characterized by distortions in perception and thinking, such as delusional perceptions, thought withdrawal, and hallucinatory voices, among others. The purpose of this monograph was to identify and describe interventions based on cognitive-behavioral therapy (CBT) for the psychological treatment of schizophrenia from the period between 2018 and 2023. The research was conducted through a comprehensive search in the PubMed database, selecting studies that addressed interventions combining CBT-based treatments with pharmacological and non-pharmacological approaches in patients with schizophrenia and prodromal symptoms. Out of the 38 identified articles, 26 meeting the inclusion criteria were included. These studies evaluated the effectiveness of combining CBT with antipsychotics in patients with a first psychotic episode, demonstrating the feasibility and safety of this intervention. Furthermore, CBT was found to be clinically effective in young patients with good functioning, improving their cognitive and work performance, as well as alleviating negative symptoms of schizophrenia. In terms of relapse prevention, CBT proved effective in treating positive symptoms, with sustained improvements one year after treatment. For symptoms such as hallucinations and sleep disorders, CBT demonstrated efficacy in controlling hallucinatory voices and normalizing and integrating the experience of hearing them. Additionally, an exposure-based CBT intervention improved acute insomnia crises. The combination of virtual reality and CBT also proved feasible, resulting in a reduction of paranoid symptoms, negative affect, and hallucinations. Regarding negative symptoms, CBT showed greater effectiveness in their control and reduction, reducing depressive symptoms and improving the overall severity of schizophrenia, as well as the functioning of patients. These findings underscore the pressing need to continue research in the field of cognitive-behavioral therapy for schizophrenia, as they offer promising perspectives for enhancing the quality of life of individuals affected by this mental disorder and open up new possibilities for treatment and rehabilitation.
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Palabras clave
Esquizofrenia, Terapia cognitivo conductual, Eficacia terapéutica, Tratamiento, Schizophrenia, Cognitive behavioral therapy, Therapeutic efficacy, Treatment
