Psychiatric hospital "Sveti Ivan", Zagreb, Croatia.
Psychiatr Danub. 2022 Fall;34(3):455-463. doi: 10.24869/psyd.2022.455.
Combat-related chronic post-traumatic stress disorder (PTSD) is a therapeutically resistant disorder of the fluctuating course. The success of a group psychotherapy is partial. The aim of this paper is to determine baseline characteristics of veterans for whom a group psychotherapy will be the effective psychotherapeutic treatment.
We performed this prospective cohort study in two geographically distant institutions: Regional Psychotrauma Center at the Psychiatric Clinic Split, and the Daily Hospital of the Psychiatric Hospital "Sveti Ivan" Zagreb, Croatia. We selected a consecutive sample of 86 veterans with combat-related chronic PTSD admitted to the group psychotherapy during 2009-2012. The primary outcome was ≥5% improvement in PTSD symptoms severity measured by Mississippi Scale for Combat-Related PTSD and adjusted for the baseline Mississippi scale score. Predictors were participants' 17 baseline sociodemographic and clinical characteristics and psychological features like personality traits, stress-coping mechanisms, and depression.
We identified two patients' segments with significantly higher likelihood for the favorable treatment outcome. The first one were patients with the low score (≤8) on the phobia scale and high score (≥7) on the hysterical personality scale. In this segment 100% of patients experienced a favorable treatment outcome. The second one were the patiens with a higher score (>8) on the phobia scale, the low score (≤12) on the free-floating anxiety scale and the high score ≥8) on the obsession scale. In this segment, 64% experienced the favorable treatment outcome.
The favorable outcome of the group psychotherapy of PTSD symptoms severity in patients with combat-related chronic PTSD can be predicted before the start of the treatment. The favorable outcome should be expected in patients with the low phobia and pronounced hysteria personality traits, or in patients with higher phobia, but with low free-floating anxiety and low obsession.
与战斗相关的慢性创伤后应激障碍（PTSD）是一种波动病程的治疗抵抗性疾病。团体心理治疗的成功率是部分的。本文的目的是确定将接受团体心理治疗的退伍军人的基线特征，这些退伍军人将是有效的心理治疗。
我们在两个地理位置不同的机构进行了这项前瞻性队列研究：斯普利特精神病诊所的区域心理创伤中心和克罗地亚萨格勒布“圣伊万”精神病院的日常医院。我们选择了 2009-2012 年期间参加团体心理治疗的 86 名患有与战斗相关的慢性 PTSD 的退伍军人的连续样本。主要结果是 PTSD 症状严重程度的改善≥5%，采用密西西比战斗相关 PTSD 量表进行测量，并根据基线密西西比量表评分进行调整。预测因子是参与者的 17 个基线社会人口统计学和临床特征以及心理特征，如人格特质、压力应对机制和抑郁。
我们确定了两个患者群体，他们有更高的可能性获得有利的治疗结果。第一个群体是恐惧症量表得分低（≤8）和癔症人格量表得分高（≥7）的患者。在这个群体中，100%的患者都经历了有利的治疗结果。第二个群体是恐惧症量表得分较高（>8）、自由浮动焦虑量表得分较低（≤12）和强迫量表得分较高（≥8）的患者。在这个群体中，64%的患者经历了有利的治疗结果。
在开始治疗之前，可以预测与战斗相关的慢性 PTSD 患者的 PTSD 症状严重程度的团体心理治疗的有利结果。在恐惧症和明显癔症人格特质较低的患者中，或在恐惧症较高但自由浮动焦虑和强迫较低的患者中，应该预期会有良好的治疗结果。
