Dept. of Neuroscience, Norwegian University of Science and Technology, 7489 Trondheim, Norway; Centre on Violence, Traumatic Stress and Suicide Prevention, Mid-Norway, St. Olav University Hospital, Schwacks Gt. 1, 7030 Trondheim, Norway.
Behav Res Ther. 2013 Oct;51(10):641-7. doi: 10.1016/j.brat.2013.07.002. Epub 2013 Jul 8.
There has been uncertainty about whether refugees and asylum seekers with PTSD can be treated effectively in standard psychiatric settings in industrialized countries. In this study, Narrative Exposure Therapy (NET) was compared to Treatment As Usual (TAU) in 11 general psychiatric health care units in Norway. The focus was on changes in symptom severity and in the diagnostic status for PTSD and depression.
Refugees and asylum seekers fulfilling the DSM-IV criteria for PTSD (N = 81) were randomized with an a-priori probability of 2:1 to either NET (N = 51) or TAU (N = 30). The patients were assessed with Clinician Administered PTSD Scale, Hamilton rating scale for depression and the MINI Neuropsychiatric Interview before treatment, and again at one and six months after the completion.
Both NET and TAU gave clinically relevant symptom reduction both in PTSD and in depression. NET gave significantly more symptom reduction compared to TAU as well as significantly more reduction in participants with PTSD diagnoses. No difference in treatment efficacy was found between refugees and asylum seekers.
The study indicated that refugees and asylum seekers can be treated successfully for PTSD and depression in the general psychiatric health care system; NET appeared to be a promising treatment for both groups.
对于患有 PTSD 的难民和寻求庇护者是否可以在工业化国家的标准精神科环境中得到有效治疗，一直存在不确定性。本研究比较了挪威 11 个综合精神卫生保健单位中的叙事暴露疗法（NET）与常规治疗（TAU）。重点是症状严重程度的变化以及 PTSD 和抑郁的诊断状况。
符合 DSM-IV PTSD 标准的难民和寻求庇护者（N=81）按事先确定的 2:1 比例随机分配至 NET（N=51）或 TAU（N=30）组。在治疗前、治疗后 1 个月和 6 个月时，使用临床医生管理的 PTSD 量表、汉密尔顿抑郁评定量表和 MINI 神经精神病学访谈对患者进行评估。
NET 和 TAU 均在 PTSD 和抑郁方面均产生了明显的临床相关症状缓解。与 TAU 相比，NET 组的症状缓解更为显著，且 PTSD 诊断患者的缓解更为显著。在治疗效果方面，难民和寻求庇护者之间没有差异。
该研究表明，难民和寻求庇护者可以在综合精神卫生保健系统中成功治疗 PTSD 和抑郁；NET 似乎对这两个群体都有很好的治疗效果。
