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成人创伤后应激障碍(PTSD)治疗临床实践指南摘要。

Summary of the clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults.

出版信息

Am Psychol. 2019 Jul-Aug;74(5):596-607. doi: 10.1037/amp0000473.


DOI:10.1037/amp0000473
PMID:31305099
Abstract

The American Psychological Association (APA) developed a clinical practice guideline (CPG) to provide recommendations on psychological and pharmacological treatments for posttraumatic stress disorder (PTSD) in adults. This paper is a summary of the CPG, including the development process. Members of the guideline development panel (GDP) used a comprehensive systematic review conducted by the Research Triangle Institute-University of North Carolina Evidence-based Practice Center (RTI-UNC EPC) as its primary evidence base (Jonas et al., 2013). The GDP consisted of health professionals from psychology, psychiatry, social work, and family medicine as well as community members who self-identified as having had PTSD. PTSD symptom reduction and serious harms were selected by the GDP as critical outcomes for making recommendations. The GDP strongly recommends use of the following psychotherapies/interventions (in alphabetical order) for adults with PTSD: cognitive-behavioral therapy, cognitive processing therapy, cognitive therapy, and prolonged exposure therapy. The GDP conditionally recommends the use of brief eclectic psychotherapy, eye movement desensitization and reprocessing (EMDR), and narrative exposure therapy (NET). For medications, the GDP conditionally recommends the following (in alphabetical order): fluoxetine, paroxetine, sertraline, and venlafaxine. There is insufficient evidence to recommend for or against offering Seeking Safety, relaxation, risperidone, and topiramate. A subgroup of the GDP reviewed studies published after the systematic review for those treatments that received substantive recommendations; the GDP concluded that future systematic reviews that incorporated those new studies could change the recommendations for EMDR and NET from conditional to strong. For all other treatments, results of the update indicated that recommendations were unlikely to change or that there were no new trials for comparison. The target audience for this CPG includes clinicians, researchers, patients, and policymakers. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

摘要

美国心理协会(APA)制定了一份临床实践指南(CPG),为成年人创伤后应激障碍(PTSD)的心理和药物治疗提供建议。本文是该 CPG 的摘要,包括其制定过程。指南制定小组(GDP)的成员使用由三角研究所-北卡罗来纳大学循证实践中心(RTI-UNC EPC)进行的全面系统评价作为其主要证据基础(Jonas 等人,2013)。GDP 由来自心理学、精神病学、社会工作和家庭医学的卫生专业人员以及自我认同患有 PTSD 的社区成员组成。GDP 将 PTSD 症状减轻和严重伤害选为提出建议的关键结果。GDP 强烈建议使用以下心理疗法/干预措施(按字母顺序排列)治疗 PTSD 成年人:认知行为疗法、认知加工疗法、认知疗法和延长暴露疗法。GDP 有条件地推荐使用简短的折衷心理疗法、眼动脱敏与再处理(EMDR)和叙事暴露疗法(NET)。对于药物,GDP 有条件地推荐以下药物(按字母顺序排列):氟西汀、帕罗西汀、舍曲林和文拉法辛。没有足够的证据推荐使用寻求安全、放松、利培酮和托吡酯。GDP 的一个小组审查了系统评价后发表的关于这些治疗方法的研究;GDP 的结论是,未来纳入这些新研究的系统评价可能会使 EMDR 和 NET 的建议从有条件改为强烈。对于所有其他治疗方法,更新结果表明,建议不太可能改变,或者没有新的试验可供比较。该 CPG 的目标受众包括临床医生、研究人员、患者和政策制定者。(PsycINFO 数据库记录(c)2019 APA,保留所有权利)。

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