Randomized controlled comparison of cognitive behavior therapy with Rogerian supportive therapy in chronic post-traumatic stress disorder: A 2-year follow-up
Randomized controlled comparison of cognitive behavior therapy with Rogerian supportive therapy in chronic post-traumatic stress disorder: A 2-year follow-up
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DOI：
10.1159/000112887
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发表时间：
2008-01-01
影响因子：
22.8
通讯作者：
Chen, Yaohua
中科院分区：
文献类型：
--
作者：
Cottraux, Jean;Note, Ivan;Chen, Yaohua
背景：到目前为止，还没有研究比较认知行为疗法（CBT）和罗杰斯疗法在创伤后应激障碍中的作用。方法：将60例符合DSM-IV慢性创伤后应激障碍的门诊患者随机分为两组，分别在两个中心接受CBT或Rogerian支持疗法（ST）治疗，每周一次，共16次。未开具任何药物。测量指标包括创伤后应激障碍量表（PCLS）、汉密尔顿焦虑量表、贝克抑郁量表和生活质量。一般改善标准（GCI）为PCLS评分小于44分。结果：42例患者在后测试时进行了评估，38例在第52周，25例在第104周。在试验后，ST组因病情恶化或缺乏有效性而退出试验的患者比例显著较高（p = 0.004）。在这一点上，在GCI和任何评定量表上都没有发现组间差异。意向治疗分析发现GCI没有差异，但CBT组患者在PCLS和汉密尔顿焦虑量表上表现出更大的改善。自然随访显示，在第52周和第104周，持续改善，无组间差异。结论：CBT比ST保留了更多的治疗患者，但其效果与完成者中的ST相当。在后测的维度意向治疗分析中，CBT更好。版权所有（c）2008 S. Karger AG，巴塞尔。
Background: To date, there have been no studies comparing cognitive behavior therapy (CBT) with Rogerian therapy in post-traumatic stress disorder. Method: Sixty outpatients with DSM-IV chronic post-traumatic stress disorder were randomized into two groups for 16 weekly individual sessions of CBT or Rogerian supportive therapy (ST) at two centers. No medication was prescribed. Measures included the Post-Traumatic Stress Disorder Checklist Scale (PCLS), the Hamilton Anxiety Scale, Beck Depression Inventory, and Quality of Life. The general criterion of improvement (GCI) was a score of less than 44 on the PCLS. Results: Forty-two patients were evaluated at post-test, 38 at week 52 and 25 at week 104. At post-test, the rate of patients leaving the trial due to worsening or lack of effectiveness was significantly higher in the ST group (p = 0.004). At this point, no between-group difference was found on the GCI and any of the rating scales. Intent-to-treat analysis found no difference for the GCI, but patients in the CBT group showed greater improvement on the PCLS and Hamilton Anxiety Scale. Naturalistic follow-up showed sustained improvement without between-group differences at weeks 52 and 104. Conclusions: CBT retained significantly more patients in treatment than ST, but its effects were equivalent to those of ST in the completers. CBT was better in the dimensional intent-to-treat analysis at post-test. Copyright (c) 2008 S. Karger AG, Basel.