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针对退伍军人创伤后应激障碍的马术辅助治疗:一项开放性试验。

Equine-Assisted Therapy for Posttraumatic Stress Disorder Among Military Veterans: An Open Trial.

作者信息

Fisher Prudence W, Lazarov Amit, Lowell Ari, Arnon Shay, Turner J Blake, Bergman Maja, Ryba Matthew, Such Sara, Marohasy Caroline, Zhu Xi, Suarez-Jimenez Benjamin, Markowitz John C, Neria Yuval

机构信息

New York State Psychiatric Institute, New York, New York.

Department of Psychiatry, Columbia University Irving Medical Center, New York, New York.

出版信息

J Clin Psychiatry. 2021 Aug 31;82(5):21m14005. doi: 10.4088/JCP.21m14005.

Abstract

As veterans have high rates of posttraumatic stress disorder (PTSD) and historically poor treatment outcomes and high attrition, alternative treatments have gained much popularity despite lack of rigorous research. In this study, a recently developed and manualized 8-session group Equine-Assisted Therapy for PTSD (EAT-PTSD) was tested in an open trial to assess its preliminary feasibility, acceptability, and outcomes for military veterans. The study was conducted from July 2016 to July 2019. Sixty-three treatment-seeking veterans with PTSD enrolled. PTSD diagnosis was ascertained using the Structured Clinical Interview for , Research Version (SCID-5-RV) and confirmed using the Clinician-Administered PTSD Scale (CAPS-5). Mean age was 50 years, and 23 patients (37%) were women. Clinician and self-report measures of PTSD and depression were assessed at pretreatment, midtreatment, and posttreatment and at a 3-month follow-up. An intent-to-treat analysis and a secondary analysis of those who completed all 4 clinical assessments were utilized. Only 5 patients (8%) withdrew from treatment, 4 before midtreatment and 1 afterward. Posttreatment assessment revealed marked reductions in both clinician-rated and self-reported PTSD and depression symptoms, which persisted at 3-month follow-up. Specifically, mean (SD) CAPS-5 scores fell from 38.6 (8.1) to 26.9 (12.4) at termination. Thirty-two patients (50.8%) showed clinically significant change (≥ 30% decrease in CAPS-5 score) at posttreatment and 34 (54.0%) at follow-up. Manualized EAT-PTSD shows promise as a potential new intervention for veterans with PTSD. It appears safe, feasible, and clinically viable. These preliminary results encourage examination of EAT-PTSD in larger, randomized controlled trials. ClinicalTrials.gov identifier: NCT03068325.

摘要

由于退伍军人创伤后应激障碍(PTSD)的发病率很高,且历来治疗效果不佳、脱落率高,尽管缺乏严格的研究,但替代疗法却颇受欢迎。在本研究中,一种最近开发的、有手册指导的为期8节的PTSD马匹辅助治疗(EAT-PTSD)在一项开放试验中进行了测试,以评估其对退伍军人的初步可行性、可接受性和治疗效果。该研究于2016年7月至2019年7月进行。63名寻求治疗的PTSD退伍军人参与其中。使用《精神疾病诊断与统计手册》研究版结构化临床访谈(SCID-5-RV)确定PTSD诊断,并使用临床医生管理的PTSD量表(CAPS-5)进行确认。平均年龄为50岁,23名患者(37%)为女性。在治疗前、治疗中期、治疗后以及3个月随访时,对PTSD和抑郁的临床医生评估及自我报告测量进行了评估。采用意向性分析以及对完成所有4次临床评估者的二次分析。只有5名患者(8%)退出治疗,4名在治疗中期前退出,1名在治疗中期后退出。治疗后评估显示,临床医生评定和自我报告的PTSD及抑郁症状均显著减轻,且在3个月随访时持续存在。具体而言,CAPS-5平均(标准差)评分在治疗结束时从38.6(8.1)降至26.9(12.4)。32名患者(50.8%)在治疗后显示出临床显著变化(CAPS-5评分降低≥30%),34名患者(54.0%)在随访时显示出临床显著变化。有手册指导的EAT-PTSD显示出有望成为治疗PTSD退伍军人的一种潜在新干预措施。它似乎是安全、可行且临床上可行的。这些初步结果鼓励在更大规模的随机对照试验中对EAT-PTSD进行研究。ClinicalTrials.gov标识符:NCT03068325。

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