生理回饋與男性思覺失調症者之執行功能

Biofeedback and Executive Function in Male Patients with Schizophrenia

目的：思覺失調症為嚴重且慢性精神疾病，除正性症狀外，常伴隨負性症狀與執行功能困難。然而現行藥物治療對後兩者改善有限。心跳變異生理回饋（HRV-BF）提升自主神經調節。本研究旨在探討男性思覺失調症者接受HRV-BF，對其執行功能及精神症狀之影響。方法：12名男性思覺失調症者接受10次HRV-BF，於HRV-BF前進行2次評估，HRV-BF後1次。評估內容分別為威斯康辛卡片分類測驗（WCST-64），與正性與負性症狀量表簡版（PANSS-8）。以相依樣本變異數分析檢驗三次評估之差異。結果：參與者接受HRV-BF後，與認知彈性相關之固著錯誤表現呈潛在改善訊號，此外，對負性症狀中特定向度，尤其冷漠／社交退縮，亦具有較明顯之潛在效益。結論：本研究初步支持，HRV-BF作為男性思覺失調症認知彈性與部分負性症狀之輔助介入，其效果可能與自主神經調節及前額葉調節功能相關機制有關。未來仍需較大樣本、對照設計與長期追蹤研究進一步驗證其療效與機制。

Objectives. Schizophrenia is a severe, chronic psychiatric disorder characterized by positive symptoms, often accompanied by negative symptoms and executive function deficits. Current pharmacological treatments show limited efficacy for the latter. Heart rate variability biofeedback (HRV-BF) enhances autonomic regulation. This study examined the effects of HRV-BF on executive function and psychiatric symptoms in individuals with male schizophrenia.
Methods. Twelve participants with male schizophrenia received 10 HRV-BF sessions. Two pre-intervention assessments and one post-intervention assessment were conducted, including the Wisconsin Card Sorting Test (WCST-64) and the Positive and Negative Syndrome Scale-8 item version (PANSS-8). Repeated measures ANOVA was used to analyze changes across the three time points.
Results. Following HRV biofeedback (HRV-BF), participants showed a potential improvement signal in perseverative errors related to cognitive flexibility, with more evident potential benefits in negative symptoms, particularly apathy/social withdrawal.
Conclusion. Findings provide preliminary support for HRV-BF as an adjunctive intervention for cognitive flexibility and selected negative symptoms in male patients with schizophrenia, potentially involving autonomic and prefrontal regulatory mechanisms. Larger controlled studies with long-term follow-up are needed to confirm efficacy and mechanisms.