The effectiveness of trauma-focused psychotherapy for complex post-traumatic stress disorder: A retrospective study.
The effectiveness of trauma-focused psychotherapy for complex post-traumatic stress disorder: A retrospective study.
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DOI：
10.1192/j.eurpsy.2022.2346
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发表时间：
2022-11-25
影响因子：
7.8
通讯作者：
Bloomfield, Michael
中科院分区：
文献类型：
--
作者：
Melegkovits, Eirini;Blumberg, Jocelyn;Dixon, Emily;Ehntholt, Kimberley;Gillard, Julia;Kayal, Hamodi;Kember, Tim;Ottisova, Livia;Walsh, Eileen;Wood, Maximillian;Gafoor, Rafael;Brewin, Chris;Billings, Jo;Robertson, Mary;Bloomfield, Michael
我们回顾性评估了创伤集中心理治疗（TF-P）与稳定和等待的平民队列患者的有效性，这些患者被国际疾病分类（ICD-11）第11版诊断为复杂创伤后应激障碍（CPTSD）。我们通过自我报告问卷、档案审查和专家-临床医生意见的三角证据，确定了3年内在专科创伤服务机构接受CPTSD治疗的患者。患者完成了基于阶段的治疗：包括症状管理和建立安全性的稳定，然后等待治疗（第1阶段）;以创伤为中心的认知行为治疗（TF-CBT）或眼动脱敏和再处理（EMDR）或TF-CBT + EMDR（第2阶段）形式的个体TF-P。我们的主要结果是第2阶段与第1阶段的PTSD症状。次要结局包括抑郁症状、功能损害和CPTSD替代指标。探索性分析比较了治疗之间的结局。记录不良结局。共纳入59例患者。与仅接受第1阶段治疗相比，完成TF-P的患者在PTSD [t（58）=-3.99，p < 0.001]、抑郁症状[t（58）=-4.41，p < 0.001]、功能障碍[t（58）=-2.26，p = 0.028]和CPTSD代理评分[t（58）= 4.69，p <0.001]方面显示出统计学显著性降低。p < 0.001]。在第2阶段提供的不同治疗之间的结局无显著差异。基线抑郁症状与较高的PTSD症状和功能障碍相关。这项研究表明，TF-P有效地改善CPTSD的症状。然而，前瞻性研究与验证测量是必要的，以评估当前和新的治疗方法，并确定个人标志物的治疗效果CPTSD。
We retrospectively evaluated the effectiveness of trauma-focused psychotherapy (TF-P) versus stabilization and waiting in a civilian cohort of patients with an 11th version of the international classification of disease (ICD-11) diagnosis of complex post-traumatic stress disorder (CPTSD). We identified patients with CPTSD treated at a specialist trauma service over a 3-year period by triangulating evidence from self-report questionnaires, file review, and expert-clinician opinion. Patients completed a phase-based treatment: stabilization consisting of symptom management and establishing safety, followed by waiting for treatment (phase 1); individual TF-P in the form of trauma-focused cognitive behavioral therapy (TF-CBT), or eye movement desensitization and reprocessing (EMDR) or TF-CBT plus EMDR (phase 2). Our primary outcome was PTSD symptoms during phase 2 versus phase 1. Secondary outcomes included depressive symptoms, functional impairment, and a proxy CPTSD measure. Exploratory analysis compared outcomes between treatments. Adverse outcomes were recorded. Fifty-nine patients were included. Compared to receiving only phase 1, patients completing TF-P showed statistically significant reductions in PTSD [t(58) = −3.99, p < 0.001], depressive symptoms [t(58) = −4.41, p < 0.001], functional impairment [t(58) = −2.26, p = 0.028], and proxy scores for CPTSD [t(58) = 4.69, p < 0.001]. There were no significant differences in outcomes between different treatments offered during phase 2. Baseline depressive symptoms were associated with higher PTSD symptoms and functional impairment. This study suggests that TF-P effectively improves symptoms of CPTSD. However, prospective research with validated measurements is necessary to evaluate current and new treatments and identify personal markers of treatment effectiveness for CPTSD.
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影响因子：
5
作者：
Elklit A;Hyland P;Shevlin M
通讯作者：
Shevlin M
影响因子：
4.1
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Cloitre, Marylene;Hyland, Philip;Shevlin, Mark
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Shevlin, Mark