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创伤后应激障碍老兵及其家庭成员的人际心理治疗:一项开放试验。

Interpersonal Psychotherapy of Posttraumatic Stress Disorder for Veterans and Family Members: An Open Trial.

机构信息

New York State Psychiatric Institute, New York City (Pickover, Lowell, Lopez-Yianilos, Sanchez-Lacay, Ryba, Such, Arnon, Amsalem, Neria, Markowitz); Department of Psychiatry, Columbia University Irving Medical Center, New York City (Pickover, Lowell, Lazarov, Sanchez-Lacay, Amsalem, Neria, Markowitz); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov); Department of Psychiatry, Weill-Cornell Medical Center, New York City (Ryba).

出版信息

Psychiatr Serv. 2021 Aug 1;72(8):866-873. doi: 10.1176/appi.ps.202000355. Epub 2021 Feb 9.

Abstract

OBJECTIVE

Military service members and veterans have high rates of posttraumatic stress disorder (PTSD), as do military family members. Exposure-based, cognitive-behavioral approaches have received ample research, but other PTSD therapies require further empirical attention. Interpersonal psychotherapy (IPT) targets affective awareness, life circumstances, and social support. IPT has shown efficacy for civilians with PTSD but awaits rigorous testing among military personnel; only two small military pilot studies and two case reports have been published. Military family members have received minimal attention from clinical outcomes research. Addressing these gaps, this open trial examined IPT for PTSD among veterans, service members, and family members, including a patient subset with comorbid PTSD and depression.

METHODS

Fifty U.S. military service members, veterans, and family members (age ≥18 years) were offered 14 sessions of IPT for PTSD. Individuals with psychosis, bipolar disorder, moderate or severe substance use disorders, or high suicide risk were excluded. PTSD and depressive symptoms were assessed at baseline, midtreatment, posttreatment, and 3-month follow-up.

RESULTS

Clinician-assessed PTSD (Clinician-Administered PTSD Scale) and depression (Hamilton Depression Rating Scale) symptoms decreased over time in the full sample and the comorbid PTSD/depression subset (p<0.05). Service members, veterans, and family members had similar treatment responses.

CONCLUSIONS

Patients receiving IPT showed reductions in PTSD and depressive symptoms. These open trial findings provide preliminary support for the utility of IPT in reducing PTSD symptoms among veterans and family members. This largest IPT trial to date for PTSD in military patients also bolsters the literature on treating military family members.

摘要

目的

军人和退役军人的创伤后应激障碍(PTSD)发生率很高,军人家属也是如此。暴露疗法和认知行为疗法已经得到了充分的研究,但其他 PTSD 疗法需要进一步的实证关注。人际心理治疗(IPT)针对情感意识、生活环境和社会支持。IPT 已被证明对 PTSD 平民有效,但在军事人员中仍需严格测试;只有两项小型军事试点研究和两项病例报告已发表。军事家属在临床结果研究中受到的关注甚少。为了解决这些差距,本开放性试验研究了 PTSD 退伍军人、现役军人和军人家属的 IPT,包括 PTSD 和抑郁共病的患者亚组。

方法

50 名美国军人、退役军人和家属(年龄≥18 岁)接受了 14 节 PTSD 的 IPT。排除精神病、双相情感障碍、中度或重度物质使用障碍或高自杀风险的个体。在基线、治疗中期、治疗后和 3 个月随访时评估 PTSD 和抑郁症状。

结果

在全样本和共病 PTSD/抑郁亚组中,临床医生评估的 PTSD(临床医生管理的 PTSD 量表)和抑郁(汉密尔顿抑郁评定量表)症状随时间推移而降低(p<0.05)。军人、退役军人和家属的治疗反应相似。

结论

接受 IPT 的患者 PTSD 和抑郁症状有所减轻。这些开放性试验结果为 IPT 在减少退伍军人和家属 PTSD 症状方面的有效性提供了初步支持。这是迄今为止针对 PTSD 的最大军事患者 IPT 试验,也为治疗军人家属的文献提供了支持。

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Psychotherapy at a Distance.远程心理疗法。
Am J Psychiatry. 2021 Mar 1;178(3):240-246. doi: 10.1176/appi.ajp.2020.20050557. Epub 2020 Sep 25.

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