Prolonged exposure and EMDR for PTSD v. a PTSD waiting-list condition: effects on symptoms of psychosis, depression and social functioning in patients with chronic psychotic disorders
Prolonged exposure and EMDR for PTSD v. a PTSD waiting-list condition: effects on symptoms of psychosis, depression and social functioning in patients with chronic psychotic disorders
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DOI：
10.1017/s0033291716001094
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发表时间：
2016-08-01
影响因子：
6.9
通讯作者：
van Minnen, A. M.
中科院分区：
文献类型：
--
作者：
de Bont, P. A. J. M.;van den Berg, D. P. G.;van Minnen, A. M.
研究背景创伤后应激障碍（PTSD）治疗对精神病患者精神症状、抑郁和社会功能的影响尚不清楚。方法采用随机对照试验（RCT），对155例门诊精神病患者进行治疗（61.3%精神分裂症，29%情感性精神障碍）被随机分为8个阶段（PE; n = 53）或眼动脱敏和再处理（EMDR）（n = 55），或等待名单条件（WL，n = 47），用于治疗他们的共病PTSD。对（1）精神病：妄想严重程度（PSYRATS-DRS）、偏执性思维（GPTS）、听觉言语幻觉（PSYRATS-AHRS）和精神病性障碍缓解（SCI-SR-PANSS）;（2）抑郁（BDI-II）;（3）社会功能（PSP）进行测量。结果进行了比较，在基线，治疗后，6个月的后续行动，并在所有datapoints.Results两个PE和EMDR显着相关的治疗后，在6个月的后续行动中，不太严重的偏执思想，并与更多的患者缓解精神分裂症，在治疗后（PE和EMDR）和随着时间的推移（PE）。此外，在治疗后和6个月随访时，PE与抑郁症的更大减少显著相关。结论在慢性精神病患者中，PE和EMDR不仅可以减轻PTSD症状，还可以减轻偏执性思维。重要的是，在PE和EMDR中，更多的患者在缓解中完成了他们的精神障碍状态。在临床上，这些影响是高度相关的，并提供经验支持的概念，提供创伤后应激障碍治疗精神病性障碍和创伤后应激障碍的患者值得越来越多的认可和接受的临床医生。
Background In patients with psychotic disorders, the effects of psychological post-traumatic stress disorder (PTSD) treatment on symptoms of psychosis, depression and social functioning are largely unknownMethod In a single-blind randomized controlled trial (RCT) 155 outpatients in treatment for psychosis (61.3% schizophrenic disorder, 29% schizoaffective disorder) were randomized to eight sessions prolonged exposure (PE; n = 53) or eye movement desensitization and reprocessing (EMDR) (n = 55), or a waiting-list condition (WL, n = 47) for treatment of their co-morbid PTSD. Measures were performed on (1) psychosis: severity of delusions (PSYRATS-DRS), paranoid thoughts (GPTS), auditory verbal hallucinations (PSYRATS-AHRS), and remission from psychotic disorder (SCI-SR-PANSS); (2) depression (BDI-II); (3) social functioning (PSP). Outcomes were compared at baseline, post-treatment, 6-month follow-up and over all data points.Results Both PE and EMDR were significantly associated with less severe paranoid thoughts post-treatment and at 6-month follow-up, and with more patients remitting from schizophrenia, at post-treatment (PE and EMDR) and over time (PE). Moreover, PE was significantly associated with a greater reduction of depression at post-treatment and at 6-month follow-up. Auditory verbal hallucinations and social functioning remained unchanged.Conclusions In patients with chronic psychotic disorders PE and EMDR not only reduced PTSD symptoms, but also paranoid thoughts. Importantly, in PE and EMDR more patients accomplished the status of their psychotic disorder in remission. Clinically, these effects are highly relevant and provide empirical support to the notion that delivering PTSD treatment to patients with psychotic disorders and PTSD deserves increasing recognition and acceptance among clinicians.