Post-traumatic stress disorder in the context of terrorism and other civil conflict in Northern Ireland: randomised controlled trial
Post-traumatic stress disorder in the context of terrorism and other civil conflict in Northern Ireland: randomised controlled trial
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DOI：
10.1136/bmj.39021.846852.be
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发表时间：
2007-06-02
影响因子：
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通讯作者：
Clark, David M.
中科院分区：
文献类型：
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作者：
Duffy, Michael;Gillespie, Kate;Clark, David M.
目的 评估认知治疗对北爱尔兰与恐怖主义和其他国内冲突相关的创伤后应激障碍的有效性。设计随机对照试验。地点为北爱尔兰社区治疗中心。参与者为 58 名连续患有慢性创伤后应激障碍的患者（中位 5.2 年，范围 3 个月至 32 年），大多由与恐怖主义和其他国内冲突相关的多重创伤引起。干预措施 立即认知治疗与随后 12 周的等待名单对照条件相比通过治疗。治疗包括12周期间平均5.9次疗程和此后2.0次疗程。 主要结果测量 主要结果测量是患者的创伤后应激障碍（创伤后应激诊断量表）和抑郁症（贝克抑郁量表）评分。次要结果指标是 Sheehan 残疾量表的职业和社会功能（工作相关残疾、社交残疾和家庭生活）得分。 结果 在随机分组后 12 周，立即认知治疗与等待名单对照组相比，在创伤后应激障碍（平均差 9.6，95% 置信区间 3.6 至 15.6）、抑郁症（平均差 10.1、4.8 至 15.3）、抑郁症（平均差 10.1、4.8 至 15.3）、自我报告的职业和社会功能（平均差 1.3、0.3 至 2.5）。治疗前后的效应值很大：创伤后应激障碍 1.25，抑郁症 1.05，职业和社会功能 1.17。对照组没有观察到任何变化。结论认知疗法是治疗与恐怖主义和其他国内冲突相关的创伤后应激障碍的有效方法。
Objective To evaluate the effectiveness of cognitive therapy for post-traumatic stress disorder related to terrorism and other civil conflict in Northern Ireland.Design Randomised controlled trial.Setting Community treatment Centre, Northern Ireland.Participants 58 consecutive patients with chronic post-traumatic stress disorder (median 5.2 years, range. 3 months to 32 years) mostly resulting from multiple traumas linked to terrorism and other civil conflict.Interventions Immediate cognitive therapy compared with a waiting list control condition for 12 weeks followed by treatment. Treatment comprised a mean of 5.9 sessions during 12 weeks and 2.0 sessions thereafter.Main outcome measures Primary outcome measures were patients' scores for post-traumatic stress disorder (post-traumatic stress diagnostic scale) and depression (Beck depression inventory). The secondary outcome measure was scores for occupational and social functioning (work related disability, social disability, and home life) on the Sheehan disability scale.Results At 12 weeks after randomisation, immediate cognitive therapy was associated with significantly greater improvement than the waiting list control group in the symptoms of post-traumatic stress disorder (mean difference 9.6, 95% confidence interval 3.6 to 15.6), depression (mean difference 10.1, 4.8 to 15.3), and self reported occupational and social functioning (mean difference 1.3, 0.3 to 2.5). Effect sizes from before to after treatment were large: post-traumatic stress disorder 1.25, depression 1.05, and occupational and social functioning 1.17. No change was observed in the control group.Conclusion Cognitive therapy is an effective treatment for post-traumatic stress disorder related to terrorism and other civil conflict.