Rory Meyers College of Nursing, New York University, New York, New York, USA.
School of Medicine, Yale University, New Haven, Connecticut, USA.
J Trauma Stress. 2020 Apr;33(2):161-170. doi: 10.1002/jts.22479. Epub 2020 Feb 19.
3,4-Methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for posttraumatic stress disorder (PTSD) has been shown to significantly reduce clinical symptomatology, but posttraumatic growth (PTG), which consists of positive changes in self-perception, interpersonal relationships, or philosophy of life, has not been studied with this treatment. Participant data (n = 60) were pooled from three Phase 2 clinical studies employing triple-blind crossover designs. Participants were required to meet DSM-IV-R criteria for PTSD with a score higher than 50 on the Clinician-Administered PTSD Scale (CAPS-IV) as well as previous inadequate response to pharmacological and/or psychotherapeutic treatment. Data were aggregated into two groups: an active MDMA dose group (75-125 mg of MDMA; n = 45) or placebo/active control (0-40 mg of MDMA; n = 15). Measures included the Posttraumatic Growth Inventory (PTGI) and the CAPS-IV, which were administered at baseline, primary endpoint, treatment exit, and 12-month follow-up. At primary endpoint, the MDMA group demonstrated more PTG, Hedges' g = 1.14, 95% CI [0.49, 1.78], p < .001; and a larger reduction in PTSD symptom severity, Hedges' g = 0.88, 95% CI [-0.28, 1.50], p < .001, relative to the control group. Relative to baseline, at the 12-month follow-up, within-subject PTG was higher, p < .001; PTSD symptom severity scores were lower, p < .001; and two-thirds of participants (67.2%) no longer met criteria for PTSD. MDMA-assisted psychotherapy for PTSD resulted in PTG and clinical symptom reductions of large-magnitude effect sizes. Results suggest that PTG may provide a new mechanism of action warranting further study.
3,4-亚甲二氧基甲基苯丙胺（MDMA）辅助心理治疗创伤后应激障碍（PTSD）已被证明可显著减轻临床症状，但创伤后成长（PTG），即自我认知、人际关系或人生观的积极变化，尚未用这种治疗方法进行研究。参与者数据（n = 60）来自三项采用三盲交叉设计的 2 期临床研究。参与者必须符合 DSM-IV-R 创伤后应激障碍标准，临床医生管理的创伤后应激障碍量表（CAPS-IV）评分高于 50 分，且先前对药物和/或心理治疗反应不足。数据汇总为两组：活性 MDMA 剂量组（75-125mg MDMA；n = 45）或安慰剂/活性对照（0-40mg MDMA；n = 15）。测量包括创伤后成长量表（PTGI）和 CAPS-IV，在基线、主要终点、治疗结束和 12 个月随访时进行测量。在主要终点，MDMA 组表现出更高的创伤后成长，Hedges'g = 1.14，95%CI [0.49, 1.78]，p <.001；以及 PTSD 症状严重程度的更大降低，Hedges'g = 0.88，95%CI [-0.28, 1.50]，p <.001，与对照组相比。与基线相比，在 12 个月随访时，个体内创伤后成长更高，p <.001；创伤后应激障碍症状严重程度评分更低，p <.001；三分之二的参与者（67.2%）不再符合 PTSD 标准。MDMA 辅助心理治疗 PTSD 导致创伤后成长和临床症状减轻，具有大效应量。结果表明，PTG 可能提供一种新的作用机制，值得进一步研究。
