Clement J. Zablocki, Milwaukee VAMC, Milwaukee, WI, USA; Department of Psychiatry, Medical College of Wisconsin, 1155 North Mayfair Road, Milwaukee, WI, 53226, USA.
Pfeiffer University, Department of Social Sciences, 48380 US-52, Misenheimer, NC, 28109, USA.
J Anxiety Disord. 2019 Apr;63:26-35. doi: 10.1016/j.janxdis.2019.01.008. Epub 2019 Jan 29.
Although residual symptoms remain following clinical treatment for posttraumatic stress disorder (PTSD), little is known about the characteristics of these residual symptoms. We aimed to determine the type, severity, and frequency of symptoms that remain after trauma-focused psychotherapy.
We conducted a systematic review of 51 randomized controlled trials of empirically supported psychosocial interventions for PTSD (68 total treatment arms). Outcomes included: 1) PTSD symptoms and 2) conditions commonly comorbid with PTSD: depression, anxiety, and quality of life impairment.
In general, the results revealed that participants who completed PTSD treatment continued to report residual PTSD symptoms: 31% reported clinical symptom levels, and 59% reported subthreshold levels at posttreatment, particularly within the hyperarousal cluster. Residual symptoms also emerged for depression (19% clinical), anxiety (55% clinical), and quality of life (36% clinical). Few differences emerged across treatment types, but differential patterns were revealed for sample/trauma types.
Results suggest a need for focused research attention to and clinical assessment of individual residual symptoms following empirically supported treatment for PTSD to determine whether further treatment sessions are warranted.
尽管创伤后应激障碍 (PTSD) 的临床治疗后仍存在残留症状，但对于这些残留症状的特征知之甚少。我们旨在确定创伤聚焦心理治疗后残留症状的类型、严重程度和频率。
我们对 51 项创伤后应激障碍的经验支持心理社会干预的随机对照试验进行了系统评价（共 68 个治疗臂）。结果包括：1）PTSD 症状和 2）常见共病 PTSD 的情况：抑郁、焦虑和生活质量受损。
一般来说，研究结果表明，完成 PTSD 治疗的参与者继续报告残留的 PTSD 症状：31%报告有临床症状水平，59%在治疗后报告有亚临床水平，特别是在过度警觉簇中。抑郁（19%临床）、焦虑（55%临床）和生活质量（36%临床）也出现了残留症状。不同的治疗类型之间几乎没有差异，但在样本/创伤类型上出现了不同的模式。
结果表明，需要对 PTSD 的经验支持治疗后出现的个体残留症状进行有针对性的研究关注和临床评估，以确定是否需要进一步的治疗。
