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有和无近期大麻使用史的退伍军人接受认知加工疗法的 PTSD 治疗结局:住宅式治疗。

Residential PTSD treatment outcomes during cognitive processing therapy for veterans with and without recent histories of cannabis use.

机构信息

Center for Clinical Management Research and Mental Health Service, VA Ann Arbor Healthcare System.

Psychology Service, Battle Creek VA Medical Center.

出版信息

Psychol Serv. 2021 Nov;18(4):497-503. doi: 10.1037/ser0000424. Epub 2020 Mar 5.

Abstract

Prior evidence has suggested that cannabis use is associated with greater posttraumatic stress disorder (PTSD) symptom severity and worse outcomes following trauma-focused treatment. However, lack of high-quality randomized studies necessitates the use of clinical data to clarify the relationship between cannabis use and PTSD treatment to help inform clinical practice. A total of 114 veterans completed cognitive processing therapy in a residential PTSD treatment program. Differences in treatment response between cannabis users and nonusers were evaluated for measures of PTSD, depression, and posttraumatic growth using analysis of covariance to control for pretreatment scores and other drug use. At baseline, cannabis users reported higher levels of PTSD symptom severity relative to nonusers but reported similar levels of depression and posttraumatic growth. Significant differences between groups in the amount of change were not observed on any of the measures from before to after treatment; however, the total sample reported significant improvements in all measures of interest. These results suggest that PTSD treatment outcomes for cannabis users may be similar to nonusers when use is stopped during treatment. Additional data are needed regarding whether outcomes remain similar at follow-up, whether cannabis users maintain abstinence after treatment, and the impact of resumed cannabis use on PTSD symptoms. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

摘要

先前的证据表明,大麻使用与创伤后应激障碍(PTSD)症状严重程度增加以及创伤聚焦治疗后结果恶化有关。然而,由于缺乏高质量的随机研究,需要使用临床数据来阐明大麻使用与 PTSD 治疗之间的关系,以帮助为临床实践提供信息。共有 114 名退伍军人在一个 PTSD 治疗项目的住院治疗中完成了认知加工治疗。使用协方差分析来控制治疗前评分和其他药物使用情况,评估大麻使用者和非使用者在 PTSD、抑郁和创伤后成长方面的治疗反应差异。在基线时,大麻使用者报告的 PTSD 症状严重程度相对高于非使用者,但报告的抑郁和创伤后成长水平相似。在治疗前后的任何测量中,都没有观察到两组之间在变化量上有显著差异;然而,总样本在所有感兴趣的测量中都报告了显著的改善。这些结果表明,当大麻使用者在治疗期间停止使用大麻时,他们的 PTSD 治疗结果可能与非使用者相似。还需要更多的数据来确定在随访时结果是否仍然相似,大麻使用者在治疗后是否保持戒断,以及重新使用大麻对 PTSD 症状的影响。(PsycInfo 数据库记录(c)2021 APA,保留所有权利)。

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