Mauritz Maria W, van Gaal Betsie G I, Goossens Peter J J, Jongedijk Ruud A, Vermeulen Hester
GGNet Center for Mental Health Care, The Netherlands; Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, The Netherlands.
Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, The Netherlands; HAN University for Applied Sciences, Nursing Studies, Nijmegen, The Netherlands.
BJPsych Open. 2020 Dec 9;7(1):e12. doi: 10.1192/bjo.2020.124.
Interpersonal trauma and post-traumatic stress disorder (PTSD) in patients with severe mental illness (SMI) negatively affect illness course. Narrative exposure therapy (NET) is effective in vulnerable patient groups, but its efficacy and applicability has not been studied in out-patients with SMI.
We aimed to evaluate the efficacy and applicability of NET in SMI on changes in PTSD, dissociation, SMI symptoms, care needs, quality of life, global functioning and care consumption.
The study had a single-group, pre-test-post-test, repeated-measures design and was registered in The Netherlands National Trial Register (identifier TR571). Primary outcomes were assessed at pre-treatment (T0), 1 month post-treatment (T1) and 7 months' follow-up (T2), with a structured interview for PTSD and dissociation screening. Secondary outcomes followed routinely SMI measurements and medical data. Mixed models were used for data analysis.
The majority of the 23 participants was female (82%). Mean age was 49.9 years (s.d. 9.8) and mean PTSD duration was 24.1 years (s.d. 14.5). Mean PTSD severity decreased from 37.9 at T0 to 31.9 at T1 (-6.0 difference, 95%CI -10.0 to -2.0), and decreased further to 24.5 at T2 (-13.4 difference, 95%CI -17.4 to -9.4). Dissociation, SMI symptoms, duration of contacts, and medication decreased; global functioning increased; and quality of life and perceived needs did not change. Eleven participants were in remission for PTSD at T2, of which five were also in remission for major depression.
NET appeared efficacious and applicable to out-patients with SMI and PTSD, and was well tolerated.
严重精神疾病（SMI）患者的人际创伤和创伤后应激障碍（PTSD）会对病程产生负面影响。叙事暴露疗法（NET）在易受伤害的患者群体中有效，但其疗效和适用性尚未在患有SMI的门诊患者中进行研究。
我们旨在评估NET对患有SMI的患者在PTSD、解离、SMI症状、护理需求、生活质量、整体功能和护理消耗方面变化的疗效和适用性。
该研究采用单组、治疗前-治疗后、重复测量设计，并在荷兰国家试验注册中心注册（标识符TR571）。在治疗前（T0）、治疗后1个月（T1）和7个月随访（T2）时评估主要结局，采用结构化访谈进行PTSD和解离筛查。次要结局按照常规的SMI测量和医疗数据进行。使用混合模型进行数据分析。
23名参与者中大多数为女性（82%）。平均年龄为49.9岁（标准差9.8），平均PTSD病程为24.1年（标准差14.5）。PTSD严重程度均值从T0时的37.9降至T1时的31.9（差异为-6.0，95%置信区间-10.0至-2.0），并在T2时进一步降至
