对重度精神疾病患者创伤后应激障碍认知重构的评估。
Evaluation of cognitive restructuring for post-traumatic stress disorder in people with severe mental illness.
作者信息
Mueser Kim T, Gottlieb Jennifer D, Xie Haiyi, Lu Weili, Yanos Philip T, Rosenberg Stanley D, Silverstein Steven M, Duva Stephanie Marcello, Minsky Shula, Wolfe Rosemarie S, McHugo Gregory J
机构信息
Kim T. Mueser, PhD, Jennifer D. Gottlieb, PhD, Center for Psychiatric Rehabilitation, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, USA; Haiyi Xie, PhD, Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth, Lebanon, USA, Weili Lu, PhD, Rutgers Biomedical and Health Sciences University, Piscataway, USA; Philip T. Yanos, PhD, John Jay College of Criminal Justice, City University of New York, New York, USA; Stanley D. Rosenberg, PhD, Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth, Lebanon, USA, Steven M. Silverstein, PhD, Stephanie Marcello Duva, PhD, Shula Minsky, PhD, Rutgers University Behavioral Health Care, Piscataway, USA; Rosemarie S. Wolfe, MS, Gregory J. McHugo, PhD, Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth, Lebanon, USA.
出版信息
Br J Psychiatry. 2015 Jun;206(6):501-8. doi: 10.1192/bjp.bp.114.147926. Epub 2015 Apr 9.
BACKGROUND
A cognitive-behavioural therapy (CBT) programme designed for post-traumatic stress disorder (PTSD) in people with severe mental illness, including breathing retraining, education and cognitive restructuring, was shown to be more effective than usual services.
AIMS
To evaluate the incremental benefit of adding cognitive restructuring to the breathing retraining and education components of the CBT programme (trial registration: clinicaltrials.gov identifier: NCT00494650).
METHOD
In all, 201 people with severe mental illness and PTSD were randomised to 12- to 16-session CBT or a 3-session brief treatment programme (breathing retraining and education). The primary outcome was PTSD symptom severity. Secondary outcomes were PTSD diagnosis, other symptoms, functioning and quality of life.
RESULTS
There was greater improvement in PTSD symptoms and functioning in the CBT group than in the brief treatment group, with both groups improving on other outcomes and effects maintained 1-year post-treatment.
CONCLUSIONS
Cognitive restructuring has a significant impact beyond breathing retraining and education in the CBT programme, reducing PTSD symptoms and improving functioning in people with severe mental illness.
背景
一项为患有严重精神疾病的创伤后应激障碍（PTSD）患者设计的认知行为疗法（CBT）项目，包括呼吸再训练、教育和认知重构，已被证明比常规服务更有效。
目的
评估在CBT项目的呼吸再训练和教育部分增加认知重构的增量效益（试验注册：clinicaltrials.gov标识符：NCT00494650）。
方法
总共201名患有严重精神疾病和PTSD的患者被随机分配到接受12至16节CBT课程或3节简短治疗课程（呼吸再训练和教育）。主要结局是PTSD症状严重程度。次要结局包括PTSD诊断、其他症状、功能和生活质量。
结果
CBT组的PTSD症状和功能改善程度大于简短治疗组，两组在其他结局方面均有改善，且治疗后1年效果得以维持。
结论
在CBT项目中，认知重构在呼吸再训练和教育之外有显著影响，可减轻患有严重精神疾病患者的PTSD症状并改善其功能。
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