Latent Profiles of Comorbid Depression as Predictors of PTSD Treatment Outcome.
Latent Profiles of Comorbid Depression as Predictors of PTSD Treatment Outcome.
复制标题
DOI：
10.1016/j.beth.2020.12.005
复制
发表时间：
2021-07
期刊：
影响因子：
3.7
通讯作者：
Zoellner LA
中科院分区：
文献类型：
--
作者：
Burton MS;Cooper AA;Mello PG;Feeny NC;Zoellner LA
创伤后应激障碍（PTSD）经常与重度抑郁症同时发生，并且经验支持的PTSD治疗始终可以改善抑郁症。然而，这两种诊断是异质性的，症状重叠的特定模式可能与更差的治疗结果有关。200名慢性创伤后应激障碍患者参加了一项双随机偏好试验，比较长期暴露和舍曲林。在开始治疗之前，使用潜在特征分析来确定基于PTSD和抑郁症状的类别。一个三级模型最适合的数据，与高抑郁和PTSD严重程度类（苦恼），中度抑郁和低PTSD回避类（抑郁），低抑郁和高PTSD回避类（回避）。回避型人群的抑郁症诊断率和易患抑郁症的比率最低。痛苦类患者经历了更强大的PTSD治疗反应，长期暴露和舍曲林之间没有差异。这些发现强调了回避在非抑郁性PTSD表现中的作用，同时也证明了在基于证据的PTSD治疗中，共发抑郁并不禁忌。
Posttraumatic stress disorder (PTSD) frequently co-occurs with major depressive disorder, and empirically supported PTSD treatments consistently improve depression. However, both diagnoses are heterogeneous and specific patterns of symptom overlap may be related to worse treatment outcome. Two hundred individuals with chronic PTSD participated in a doubly randomized preference trial comparing prolonged exposure and sertraline. Latent Profile Analysis was used to identify classes based on PTSD and depression symptoms prior to starting treatment. A three-class model best fit the data, with a high depression and PTSD severity class (distressed), a moderate depression and low PTSD avoidance class (depressive), and a low depression and high PTSD avoidance class (avoidant). The avoidant class showed the lowest rates of major depressive disorder diagnosis and transdiagnostic vulnerabilities to depression. Patients in the distressed class experienced more robust PTSD treatment response, with no differences between prolonged exposure and sertraline. These findings highlight the role of avoidance in nondepressed PTSD presentations while also demonstrating that co-occurring depression is not contraindicated in evidence-based PTSD treatment.
登录
查看更多内容
影响因子：
4.1
作者：
Cox, BJ;MacPherson, PSR;McWilliams, LA
通讯作者：
McWilliams, LA
影响因子：
12.8
作者：
Cooper, Andrew A.;Conklin, Laren R.
通讯作者：
Conklin, Laren R.
影响因子：
7.6
作者：
COSTA, PT;MCCRAE, RR
通讯作者：
MCCRAE, RR
影响因子：
--
作者：
BECK, AT;ERBAUGH, J;MENDELSOHN, M
通讯作者：
MENDELSOHN, M
影响因子：
3.1
作者：
Crawford, JR;Henry, JD
通讯作者：
Henry, JD