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[创伤后应激障碍的个性化心理治疗:使用统计程序选择治疗方法和技术的概述]

[Personalized psychotherapy of posttraumatic stress disorder : Overview on the selection of treatment methods and techniques using statistical procedures].

作者信息

Steuwe Carolin, Blaß Jakob, Herpertz Sabine C, Drießen Martin

机构信息

Universitätsklinik für Psychiatrie und Psychotherapie, Ev. Klinikum Bethel, Universitätsklinikum OWL der Universität Bielefeld, Remterweg 69-71, 33617, Bielefeld, Deutschland.

Klinik für Allgemeine Psychiatrie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland.

出版信息

Nervenarzt. 2023 Nov;94(11):1050-1058. doi: 10.1007/s00115-023-01549-6. Epub 2023 Sep 27.

Abstract

BACKGROUND

A relevant heterogeneity of treatment effects in posttraumatic stress disorder (PTSD) is discussed with respect to the debate about the necessity of phase-based treatment and in light of the new diagnosis of complex PTSD and has recently been proven; however, there has been little personalization in the treatment of PTSD. This article presents the current state of research on the personalized selection of specific psychotherapeutic methods for the treatment of PTSD based on patient characteristics using statistical methods.

METHODS

A systematic literature search was conducted in the PubMed (including Medline), Embase, Web of Science Core Collection, Google Scholar, PsycINFO and PSYNDEX databases to identify clinical trials and reviews examining personalized treatment for PTSD.

RESULTS

A total of 13 relevant publications were identified, of which 5 articles were predictor analyses in samples without control conditions and 7 articles showed analyses of randomized controlled trials (RCT) with a post hoc comparison of treatment effects in optimally and nonoptimally assigned patients. In addition, one article was a systematic review on the treatment of patients with comorbid borderline personality order and PTSD.

DISCUSSION

The available manuscripts indicate the importance and benefits of personalized treatment in PTSD. The relevant predictor variables identified for personalization should be used as a suggestion to investigate them in future prospective studies.

摘要

背景

关于创伤后应激障碍(PTSD)治疗效果的相关异质性,在基于阶段治疗必要性的讨论中以及鉴于复杂性PTSD的新诊断而被提及,并且最近已得到证实;然而,PTSD的治疗中很少有个性化治疗。本文介绍了使用统计方法根据患者特征对PTSD治疗进行特定心理治疗方法个性化选择的研究现状。

方法

在PubMed(包括Medline)、Embase、科学网核心合集、谷歌学术、PsycINFO和PSYNDEX数据库中进行系统文献检索,以识别研究PTSD个性化治疗的临床试验和综述。

结果

共识别出13篇相关出版物,其中5篇文章是在无对照条件样本中的预测分析,7篇文章展示了对随机对照试验(RCT)的分析,并对最佳和非最佳分配患者的治疗效果进行事后比较。此外,有一篇文章是关于合并边缘型人格障碍和PTSD患者治疗的系统综述。

讨论

现有手稿表明PTSD个性化治疗的重要性和益处。为个性化识别出的相关预测变量应用作建议,以便在未来的前瞻性研究中对其进行调查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3000/10620257/882c4b803a97/115_2023_1549_Fig1_HTML.jpg

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