Department of Psychiatry, Chaim Sheba Medical Center, Tel Hashomer, Israel.
J Clin Psychiatry. 2011 Sep;72(9):1174-80. doi: 10.4088/JCP.09m05682blu. Epub 2010 Nov 16.
Empirically based studies have demonstrated that prolonged exposure therapy effectively reduces posttraumatic stress disorder (PTSD) symptoms in a vast range of traumas, yet reports of the efficacy of such therapies in combat- and terror-related PTSD are scarce. In this article, we examine the efficacy of prolonged exposure therapy in combat- and terror-related PTSD in comparison to treatment as usual (TAU).
Between July 2002 and October 2005, 30 patients of a trauma unit within a psychiatric outpatient clinic were recruited and randomized into prolonged exposure versus TAU therapies. Patients were diagnosed with chronic PTSD (Mini-International Neuropsychiatric Interview criteria) related to combat- (n = 19) or terror-related (n = 11) trauma. Main outcome measures included symptoms of PTSD and depression, as measured by the PTSD Symptom Scale-Interview Version and the Beck Depression Inventory.
Posttraumatic stress disorder symptom severity was significantly lower in patients who received prolonged exposure therapy in comparison to patients who received TAU (F(1,24) = 35.3, P < .001). Similar results have emerged in measures of depression and state and trait anxiety. In addition, a significant change from pretreatment to follow-up was found for the prolonged exposure group (F(1,14) = 80.5, P < .0001), but not for the TAU group (F(1,10.3) = 0.6, P = .44).
Findings indicate that, similar to PTSD related to other types of trauma, prolonged exposure therapy is beneficial in the amelioration of combat- and terror-related PTSD symptoms. In addition, prolonged exposure was superior to TAU in the short- and long-term reduction of PTSD and depression symptoms.
clinicaltrials.gov Identifier: NCT00229372.
基于实证的研究已经证明，延长暴露疗法在广泛的创伤后有效减轻创伤后应激障碍（PTSD）症状，但关于这种疗法在战斗和恐怖相关 PTSD 中的疗效的报告却很少。在本文中，我们将比较延长暴露疗法与常规治疗（TAU）在战斗和恐怖相关 PTSD 中的疗效。
在 2002 年 7 月至 2005 年 10 月期间，我们从一家精神科门诊的创伤病房招募了 30 名患者，并将他们随机分配到延长暴露组和 TAU 组。患者被诊断为与战斗（n = 19）或恐怖相关（n = 11）创伤相关的慢性 PTSD（Mini-International Neuropsychiatric Interview 标准）。主要的结局测量包括 PTSD 症状和抑郁症状，通过 PTSD 症状量表访谈版和贝克抑郁量表进行测量。
与接受 TAU 的患者相比，接受延长暴露治疗的患者 PTSD 症状严重程度显著降低（F（1,24）= 35.3，P<.001）。在抑郁、状态和特质焦虑的测量中也出现了类似的结果。此外，在延长暴露组中，从治疗前到随访期有显著的变化（F（1,14）= 80.5，P<.0001），而在 TAU 组中没有（F（1,10.3）= 0.6，P=.44）。
研究结果表明，与其他类型创伤相关的 PTSD 一样，延长暴露疗法对改善战斗和恐怖相关 PTSD 症状是有益的。此外，在短期和长期内，延长暴露疗法在减轻 PTSD 和抑郁症状方面优于 TAU。
clinicaltrials.gov 标识符：NCT00229372。
