自閉スペクトラム症成人の生活機能を改善―社会認知スキルトレーニング日本版の開発―

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2026-08-03 京都大学

京都大学の研究グループは、米国で統合失調症向けに開発された**社会認知スキルトレーニング(SCST)**を日本向けに改良し、統合失調症および自閉スペクトラム症(ASD)の成人を対象としたランダム化比較試験を実施した。社会認知とは、他者の感情や意図を理解し対人関係に活用する能力である。試験の結果、両疾患において表情から感情を読み取る能力が改善したほか、ASD成人では「心の理論(他者の心を推測する能力)」の改善傾向に加え、日常生活や社会生活に関わる生活機能の向上も認められた。ASD成人にSCSTを適用し、生活機能改善の有効性を示したのは初めてであり、心理社会的支援の新たなエビデンスとなる。今後は、社会認知の障害を共有するさまざまな精神疾患に対する疾患横断的な治療プログラムの開発や、個々の特性に応じた個別化支援との組み合わせによる、より効果的なリハビリテーションや生活支援への応用が期待される。

自閉スペクトラム症成人の生活機能を改善―社会認知スキルトレーニング日本版の開発―
社会認知スキルトレーニングのイメージ図:
イラスト作成:大塚貞男、OpenAI ChatGPT(GPT-5、画像生成機能)を用いて作成

<関連情報>

統合失調症と⾃閉スペクトラム症における社会認知スキルトレーニングの異なる効果:評価者盲検・多施設ランダム化⽐較試験 Different effects of social cognitive skills training in schizophrenia and autism spectrum disorder: A rater-blinded, multicenter, randomized controlled trial

Sadao Otsuka PhD, Satsuki Oe MPH, Sumie Yamada PhD, Haruka Kumoi MHS, Ryoichi Suwabe MA, Tatsuro Iwane MHS, Kosuke Tsurumi MD, PhD, Toshiya Murai MD, PhD
Psychiatry and Clinical Neurosciences  Published: 22 July 2026
DOI:https://doi.org/10.1111/pcn.70106

Abstract

Aim
Schizophrenia (SCZ) and autism spectrum disorder (ASD) are both characterized by social cognitive impairments that strongly predict poor functional outcomes. However, evidence-based social cognitive interventions have been developed only for SCZ. This study investigated the feasibility and efficacy of social cognitive skills training (SCST), focusing on both common and different effects on SCZ and ASD.

Methods
Forty-seven adults with SCZ and/or ASD were randomly assigned to SCST (n = 24) or a treatment-as-usual control (CON; n = 23). The Japanese version of SCST developed for this study comprised weekly 2-h group sessions over 6 weeks and targeted two social cognition levels: lower-level emotional processing and higher-level theory of mind. Blinded raters assessed social cognition, neurocognition, clinical symptoms, and functioning at baseline, post-intervention, and 6-week follow-up.

Results
SCST significantly improved facial emotion perception across diagnoses and demonstrated a trend-level ASD-specific improvement in theory of mind. These effects were maintained and generalized to improved global functioning only for ASD at follow-up. High attendance and positive participant feedback in both groups indicated the intervention’s feasibility.

Conclusion
This study provides initial evidence supporting the feasibility and efficacy of social cognitive interventions as a transdiagnostic approach for SCZ and ASD and is the first to show functional benefits in adults with ASD. The findings highlight both shared and disorder-specific mechanisms of social cognitive impairments and support the development of hybrid interventions that integrate transdiagnostic core components with tailored, diagnosis-sensitive modules for diverse psychiatric populations.

Clinical Trial Registration
The study protocol was preregistered on the University Hospital Medical Information Network Clinical Trials Registry (UMIN000041619; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000047105; September 7, 2020).

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