Purpose Antipsychotic medications have limited efficacy in improving cognitive function and social rehabilitation in patients with schizophrenia. Based on Beck’s cognitive theory, this study developed a structured educational programme and evaluated its short-term intervention effects on patients with schizophrenia presenting with delusional symptoms. Methods We selected 102 patients with schizophrenia presenting with delusional symptoms from our hospital between January and December 2024, and randomly divided them into an observation group and a control group, each comprising 51 patients. The control group received standard pharmacological treatment and psychiatric care, whilst the observation group underwent an additional four weeks of scenario-based educational training based on the cognitive structure framework. Assessment was conducted using the SCSQ, C-CDRS, DACOBS and ERP-P300. Results Forty-seven patients in the observation group and 45 in the control group completed the training. In the observation group, the SCSQ score for the positive coping factor was higher than that of the control group, whilst the score for the negative coping factor was significantly lower (P 0.05); the total C-CDRS score and scores for each subscale, the total DACOBS score, and scores for safety behaviour and hasty conclusions were all superior to those of the control group (P 0.05); the latencies of N1, N2 and P3 were shortened, and the amplitudes of N1 and P3 were increased (P 0.05). Conclusion Scenario-based education based on the cognitive structure framework can selectively improve patients’ coping strategies, delusional symptoms and certain cognitive distortions in the short term, accompanied by changes in neurophysiological indicators. However, the link between these changes and improvements in clinical cognitive function remains unclear. This study is a preliminary exploration; as it lacks a control group with matched characteristics and long-term follow-up, its conclusions are exploratory in nature.
Hou et al. (2026) studied this question.