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精神病性谱系障碍患者创伤后应激障碍延长暴露疗法的可行性与疗效

Feasibility and Efficacy of Prolonged Exposure for PTSD among Individuals with a Psychotic Spectrum Disorder.

作者信息

Grubaugh Anouk L, Veronee Kimberly, Ellis Charles, Brown Wilson, Knapp Rebecca G

机构信息

Ralph H. Johnson Veterans Affairs Medical Center, CharlestonSC, United States.

Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, CharlestonSC, United States.

出版信息

Front Psychol. 2017 Jun 28;8:977. doi: 10.3389/fpsyg.2017.00977. eCollection 2017.

Abstract

Few empirical studies have examined the feasibility of trauma-focused treatment among individuals with schizophrenia. This lack of research is important given the substantial overlap of trauma exposure and subsequent PTSD with psychotic spectrum disorders, and the potential for PTSD to complicate the course and prognosis of schizophrenia and other variants of severe mental illness. As part of a larger study, 14 veterans with a psychotic spectrum disorder were enrolled to receive prolonged exposure (PE) for PTSD within a single arm open trial study design. Patient reactions and responses to PE were examined using feasibility indices such as attrition, survey reactions, and treatment expectancy; pre and post-changes in PTSD severity and diagnostic status; and thematic interviews conducted post-intervention. Quantitative and qualitative data indicate that implementation of PE is feasible, subjectively well-tolerated, and may result in clinically significant reductions in PTSD symptoms in patients with psychotic spectrum disorders. Consistent with treatment outcome data in clinical populations with a broader range of severe mental illnesses, the current results support the use of PTSD exposure-based interventions, such as PE, for individuals with psychotic spectrum disorders.

摘要

很少有实证研究检验过针对精神分裂症患者进行创伤聚焦治疗的可行性。鉴于创伤暴露及后续创伤后应激障碍(PTSD)与精神病性谱系障碍有大量重叠,且PTSD有可能使精神分裂症及其他严重精神疾病变体的病程和预后复杂化,这种研究的缺失就显得很重要。作为一项更大规模研究的一部分,14名患有精神病性谱系障碍的退伍军人被纳入一项单组开放性试验研究设计,接受针对PTSD的延长暴露疗法(PE)。使用诸如损耗率、调查反馈和治疗预期等可行性指标,检查患者对PE的反应;PTSD严重程度和诊断状态的干预前后变化;以及干预后进行的主题访谈。定量和定性数据表明,实施PE是可行的,患者主观耐受性良好,并且可能会使患有精神病性谱系障碍的患者的PTSD症状在临床上显著减轻。与患有更广泛严重精神疾病的临床人群的治疗结果数据一致,当前结果支持对患有精神病性谱系障碍的个体使用基于暴露的PTSD干预措施,如PE。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3c6/5488794/56bde3c248a7/fpsyg-08-00977-g001.jpg

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