Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht, The Netherlands.
Department of Treatment and Guidance, Envida, Care for Elderly, Maastricht, The Netherlands.
Psychogeriatrics. 2023 May;23(3):523-534. doi: 10.1111/psyg.12951. Epub 2023 Mar 17.
Post-traumatic stress disorder (PTSD) is associated with cognitive dysfunctions and is an independent risk factor for dementia. A recent study has found the prevalence of PTSD in people with dementia is 4.7%-7.8%. However, little is known about the effectiveness of PTSD treatment for people with dementia. The primary aim of the current study is to review previous studies on the treatment of PTSD in people with dementia. A structured literature review was performed using a 'Preferred Reporting Items for Systematic Reviews and Meta-Analyses' analysis in PubMed, Embase, PsycINFO and CINAHL. Two independent researchers screened titles and abstracts. The inclusion criteria were: PTSD symptoms present, diagnosis of dementia, PTSD treatment form described and effects of the treatment mentioned. Articles that matched these criteria were included and content and quality were analyzed. We included nine articles, all case reports, with a total of 11 cases. The discussed treatment options are eye movement desensitisation and reprocessing (EMDR) (n = 3), prolonged exposure (n = 1), cognitive behavioural therapy (n = 1) and pharmacological treatment (n = 4). All articles reported a positive effect of the intervention on several monitored symptoms. Evidence for positive effects and feasibility of EMDR were most reliable, and it was applied in two articles of sufficient quality published in 2018 and 2019. EMDR 'on-the-spot' was described with positive effect in one article in which three cases were discussed. The quality of included papers ranged from insufficient to sufficient. This review shows that people with PTSD and dementia can benefit from PTSD treatment. EMDR, prolonged exposure, acceptance and commitment therapy and pharmacological treatment are applicable in this population. EMDR treatment is most described in this population (n = 5) and shows positive results, and the studies are of sufficient quality (n = 3). Further research in the form of a randomised controlled trial is required to study the effectivity of different treatment interventions in this population.
创伤后应激障碍（PTSD）与认知功能障碍有关，是痴呆的独立危险因素。最近的一项研究发现，痴呆患者中 PTSD 的患病率为 4.7%-7.8%。然而，对于痴呆患者 PTSD 的治疗效果知之甚少。本研究的主要目的是综述既往关于痴呆患者 PTSD 治疗的研究。我们在 PubMed、Embase、PsycINFO 和 CINAHL 中使用“系统评价和荟萃分析的首选报告项目”进行了结构化文献综述。两名独立的研究人员筛选了标题和摘要。纳入标准为：存在 PTSD 症状、痴呆诊断、描述 PTSD 治疗形式和提及治疗效果。符合这些标准的文章被纳入，并对内容和质量进行了分析。我们共纳入 9 篇文章，均为病例报告，共纳入 11 例。讨论的治疗选择包括眼动脱敏再处理（EMDR）（n=3）、延长暴露（n=1）、认知行为疗法（n=1）和药物治疗（n=4）。所有文章均报告干预对几种监测症状有积极影响。EMDR 的效果和可行性证据最可靠，并且在 2018 年和 2019 年发表的两篇质量足够的文章中得到了应用。一篇文章描述了 EMDR“现场”的积极效果，其中讨论了三个案例。纳入论文的质量从不足到足够不等。本综述表明，患有 PTSD 和痴呆症的人可以从 PTSD 治疗中受益。EMDR、延长暴露、接受与承诺疗法和药物治疗适用于该人群。在该人群中（n=5）对 EMDR 治疗的描述最多，并显示出积极的结果，并且这些研究的质量（n=3）足够。需要进一步以随机对照试验的形式开展研究，以研究不同治疗干预措施在该人群中的效果。
