Sonne Charlotte, Carlsson Jessica, Bech Per, Mortensen Erik Lykke
University of Southern Denmark.
Mental Health Centre Ballerup.
Transcult Psychiatry. 2017 Apr;54(2):260-280. doi: 10.1177/1363461516682180. Epub 2016 Dec 12.
There is a dearth of evidence on the effectiveness of pharmacological treatment for refugees with trauma-related disorders. The present paper provides an overview of available literature on the subject and discusses the transferability of results from studies on other groups of patients with post traumatic stress disorder (PTSD). We conducted a systematic review of published treatment outcome studies on PTSD and depression among refugees. Fifteen studies were identified and reviewed. Most studies focused on the use of antidepressants. Included studies differed widely in method and quality. The majority were observational studies and case studies. Small sample sizes limited the statistical power. Few studies reported effect sizes, confidence intervals, and statistical significance of findings. No specific pharmacological treatment for PTSD among refugees can be recommended on the basis of the available literature. There is a need for well-designed clinical trials, especially with newer antidepressants and antipsychotics. Until such studies are available, clinical practice and design of trials can be guided by results from studies of other groups of PTSD patients, although differences in pharmacogenetics, compliance, and trauma reactions may affect the direct transferability of results from studies on nonrefugee populations.
关于药物治疗对患有创伤相关障碍的难民的有效性，证据不足。本文概述了关于该主题的现有文献，并讨论了创伤后应激障碍（PTSD）其他患者群体研究结果的可转移性。我们对已发表的难民中PTSD和抑郁症治疗结果研究进行了系统综述。确定并审查了15项研究。大多数研究集中在抗抑郁药的使用上。纳入的研究在方法和质量上差异很大。大多数是观察性研究和案例研究。小样本量限制了统计效力。很少有研究报告效应大小、置信区间和研究结果的统计学意义。根据现有文献，无法推荐针对难民中PTSD的特定药物治疗。需要精心设计的临床试验，尤其是使用新型抗抑郁药和抗精神病药的试验。在有此类研究之前，临床实践和试验设计可以参考其他PTSD患者群体的研究结果，尽管药物遗传学、依从性和创伤反应的差异可能会影响非难民群体研究结果的直接可转移性。
