Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, University College London, London, UK; Division of Psychiatry, University College London, Institute of Mental Health, and Clinical Psychopharmacology Unit, Research Department of Clinical and Health Psychology, Division of Psychology, University College London, London, UK; The Traumatic Stress Clinic, Camden and Islington NHS Foundation Trust, London, UK; St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, UK; National Institute for Health Research University College London Hospitals Biomedical Research Centre, University College Hospital, London, UK; National Hospital for Neurology and Neurosurgery, London, UK.
Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, University College London, London, UK.
Lancet Psychiatry. 2020 May;7(5):449-462. doi: 10.1016/S2215-0366(20)30041-9. Epub 2020 Jan 28.
Developmental trauma is associated with an increased risk of psychosis and predicts poor prognosis. Despite this association, little is known about which treatments work best for survivors of developmental trauma with psychosis. We sought to do the first review, to our knowledge, to investigate treatments for people with psychotic and dissociative symptoms who have a history of developmental trauma. We searched MEDLINE, PsychINFO, and Google Scholar for studies reporting psychological and pharmacological treatments of psychotic or dissociative symptoms in adult survivors of developmental trauma. We identified 24 studies, most of which investigated various modalities of psychotherapy with two case reports of pharmacological treatments. There is preliminary evidence in favour of third wave cognitive therapies. However, because of low methodological quality and reporting in most of the studies found, it remains unknown which treatments are most effective in this clinical group. Nonetheless, our findings of potential treatment targets, including emotion regulation, acceptance, interpersonal skills, trauma re-processing, and the integration of dissociated ego states, could guide future work in this area. Methodologically rigorous studies are needed to enable clinicians and patients to collaboratively form evidence-based treatment plans. Our Review is registered with PROSPERO, number CRD42018104533.
发展性创伤与精神病风险增加有关，并预示着预后不良。尽管存在这种关联，但对于经历过发展性创伤并伴有精神病的幸存者，哪些治疗方法最有效，人们知之甚少。我们旨在进行首次综述，据我们所知，旨在调查针对有发展性创伤史的伴有精神病和分离症状的人群的治疗方法。我们检索了 MEDLINE、PsychINFO 和 Google Scholar，以寻找报告针对发展性创伤成年幸存者的精神病或分离症状的心理和药物治疗的研究。我们确定了 24 项研究，其中大多数研究了各种形式的心理治疗，有两例药物治疗的病例报告。有初步证据支持第三波认知疗法。然而，由于大多数研究的方法学质量和报告都很低，因此仍不清楚哪种治疗方法对这一临床群体最有效。尽管如此，我们发现的潜在治疗目标，包括情绪调节、接受、人际交往技巧、创伤再处理和分离自我状态的整合，可以为该领域的未来工作提供指导。需要进行严格的方法学研究，以使临床医生和患者能够共同制定基于证据的治疗计划。我们的综述在 PROSPERO 上注册，编号为 CRD42018104533。
