Department of Public Health, Erasmus MC-University Medical Center, Rotterdam, the Netherlands.
Department of Public Health, Erasmus MC-University Medical Center, Rotterdam, the Netherlands.
Clin Psychol Rev. 2019 Nov;73:101776. doi: 10.1016/j.cpr.2019.101776. Epub 2019 Oct 31.
Posttraumatic stress disorder (PTSD) frequently co-occurs with traumatic brain injury (TBI). We conducted a systematic review to evaluate the appropriateness and effectiveness of treatments for PTSD in adult patients with a history of TBI. We searched for longitudinal studies aimed at treatments for PTSD patients who sustained a TBI, published in English between 1980 and February 2019. Twenty-three studies were found eligible, and 26 case studies were included for a separate overview. The quality of eligible studies was assessed using the Research Triangle Institute item bank. The majority of studies included types of cognitive-behavioral therapy (CBT) in male service members and veterans with a history of mild TBI in the United States. Studies using prolonged exposure (PE), cognitive-processing therapy (CPT) or other types of CBT, usually in combination with additional treatments, showed favorable outcomes. A smaller number of studies described complementary and novel therapies, which showed promising results. Overall, the quality of studies was considered low. We concluded that CBT seem appropriate for the patient population with history of TBI. The evidence is less strong for other therapies. We recommend controlled studies of PTSD treatments including more female patients and those with a history of moderate to severe TBIs in civilian and military populations.
创伤后应激障碍（PTSD）常与创伤性脑损伤（TBI）同时发生。我们进行了一项系统评价，以评估针对有 TBI 病史的成年 PTSD 患者的治疗方法的适当性和有效性。我们检索了 1980 年至 2019 年 2 月间发表的针对 PTSD 患者的 TBI 治疗的纵向研究，这些研究均为英文文献。有 23 项研究符合纳入标准，另有 26 项病例研究被单独概述。使用 Research Triangle Institute 项目库评估合格研究的质量。大多数研究纳入了美国轻度 TBI 病史的男性军人和退伍军人的认知行为疗法（CBT）类型。使用延长暴露（PE）、认知加工疗法（CPT）或其他类型的 CBT 的研究，通常结合其他治疗方法，显示出有利的结果。少数研究描述了补充和新颖的疗法，显示出有希望的结果。总体而言，研究质量被认为较低。我们得出结论，CBT 似乎适用于有 TBI 病史的患者群体。其他疗法的证据则较弱。我们建议在平民和军人人群中进行 PTSD 治疗的对照研究，包括更多的女性患者和中度至重度 TBI 病史的患者。
