Peritraumatic tonic immobility predicts a poor response to pharmacological treatment in victims of urban violence with PTSD
Peritraumatic tonic immobility predicts a poor response to pharmacological treatment in victims of urban violence with PTSD
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DOI：
10.1016/j.jad.2007.07.015
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发表时间：
2008-04-01
影响因子：
6.6
通讯作者：
Figueira, Ivan
中科院分区：
文献类型：
--
作者：
Fiszman, Adriana;Mendlowicz, Mauro V.;Figueira, Ivan
简介：强直性不动是动物抵抗捕食的最后一道防线，其特征是麻痹和镇痛。在人类中，仅在性虐待的女性受害者中有报道。目的：本研究评估了创伤后应激障碍患者围创伤期强直性不动（PTI）的患病率，并调查了其与治疗反应的关系。方法：通过SCID-IV（n-23）诊断为PTSD的城市暴力受害者根据PTSD的推荐指南接受了自然药理学治疗。在基线和终点应用创伤后应激障碍量表-平民版（PCL-C）和临床总体应激障碍（CGI）严重程度评分。使用强直性不动量表评估PTI。结果：43%的样本中男女都报告了PTI。无论是PCL-C还是CGI评分，PTI患者对治疗的反应均显著低于无PTI患者。局限性：本研究回顾性探讨了PTI，并基于三级诊所招募的小样本。结论：我们扩大了前两次关于创伤后感染的调查范围，表明在男子和非性暴力期间也发生创伤后感染。此外，PTI和PTSD治疗反应不良之间的显着关系的发现表明，PTI可能携带这种疾病的预后价值，并建议PTI应定期评估创伤患者。(C)2007 Elsevier B. V.保留所有权利。
Introduction: Tonic immobility is the last defense against predation in animals and is characterized by paralysis and analgesia. In humans, it has only been reported in women victims of sexual abuse. Objective: This study evaluated the prevalence of peritraumatic tonic immobility (PTI) in patients with PTSD and investigated its association with response to treatment. Method: Victims of urban violence with PTSD diagnosed through the SCID-IV (n-23) underwent a naturalistic pharmacological treatment according to the recommended guidelines for PTSD. The Post-Traumatic Stress Disorder Checklist - Civilian Version (PCL-C) and the Clinical Global Impressions (CGI) Severity scores were applied at baseline and endpoint. PTI was assessed using the Tonic Immobility Scale. Results: PTI was reported by both genders in 43% of the sample. Patients with PTI responded significantly poorly to treatment than those without it, either considering the PCL-C or the CGI scores. Limitations: This study probed PTI retrospectively and was based on a small sample recruited in a tertiary clinic. Conclusions: We have expanded the scope of the two previous investigations on PTI by showing its occurrence also in men and during non-sexual violence. In addition, the finding of a significant relationship between PTI and poor response to treatment of PTSD indicates that PTI may carry a prognostic value in this disorder and suggests that PTI should be routinely assessed in traumatized patients. (C) 2007 Elsevier B.V. All rights reserved.