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三种延长暴露疗法对儿童期受虐待相关 PTSD 患者合并诊断的影响。

Impact of three variants of prolonged exposure therapy on comorbid diagnoses in patients with childhood abuse-related PTSD.

机构信息

Department of Clinical Psychology, Leiden University, Leiden, The Netherlands.

Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.

出版信息

Cogn Behav Ther. 2024 Jul;53(4):377-393. doi: 10.1080/16506073.2024.2318729. Epub 2024 Feb 27.

Abstract

Recent studies indicated that Prolonged Exposure (PE) is safe and effective for posttraumatic stress disorder (PTSD). It is unclear whether PE also leads to a reduction in comorbid diagnoses. Data from a large randomized controlled trial ( = 149) on the effects of three variants of PE for PTSD were used. We examined the treatment effects on co-morbid diagnoses of depressive, anxiety, obsessive compulsive, substance abuse, psychotic, eating and personality disorders in a sample of patients with PTSD related to childhood abuse. Outcomes were assessed with clinical interviews at baseline, post-treatment and at 6- and 12-month follow-up. All variants of PE led to a decrease from baseline to post-treatment in diagnoses of depressive, anxiety, substance use and personality disorders. Improvements were sustained during follow-up. We found an additional decrease in the number of patients that fulfilled the diagnostic criteria of a depressive disorder between 6- and 12-month follow-up. No significant changes were observed for the presence of OCD, psychotic and eating disorders. Findings suggest that it is effective to treat PTSD related to childhood abuse with trauma-focused treatments since our 14-to-16 weeks PE for PTSD resulted in reductions in comorbid diagnoses of depressive, anxiety, substance use and personality disorders.

摘要

最近的研究表明,延长暴露(PE)治疗创伤后应激障碍(PTSD)是安全有效的。目前尚不清楚 PE 是否也会导致合并诊断的减少。本研究使用了一项关于三种不同形式的 PE 治疗 PTSD 的大型随机对照试验( = 149)的数据。我们在一组与儿童期虐待相关的 PTSD 患者中,研究了 PE 对抑郁、焦虑、强迫症、物质滥用、精神障碍、饮食和人格障碍等合并诊断的治疗效果。在基线、治疗后以及 6 个月和 12 个月随访时,使用临床访谈评估了结局。所有形式的 PE 都导致从基线到治疗后的抑郁、焦虑、物质使用和人格障碍诊断减少。在随访期间,这些改善得以维持。我们发现,在 6 至 12 个月随访时,符合抑郁障碍诊断标准的患者人数进一步减少。强迫症、精神障碍和饮食障碍的存在没有明显变化。研究结果表明,针对创伤的治疗方法治疗与儿童期虐待相关的 PTSD 是有效的,因为我们的 PTSD 14-16 周 PE 治疗导致抑郁、焦虑、物质使用和人格障碍等合并诊断减少。

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