Prolonged Exposure for Posttraumatic Stress Disorder in Patients Exhibiting Psychotic Symptoms: A Scoping Review

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy Pub Date : 2024-07-29 DOI:10.1002/cpp.3027

D. H. K. Deleuran, O. Skov, S. Bo

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Abstract

Background

Trauma is a significant risk factor for developing psychosis. Nevertheless, psychosis is often considered grounds for not receiving trauma-focused therapy due to concerns of exacerbating psychotic symptoms. Prolonged exposure (PE) is a recognized and effective evidence-based therapy modality for the treatment of severe trauma.

Objective

To assess the available empirical evidence for PE as a feasible treatment programme for posttraumatic stress disorder (PTSD) in patients with psychotic symptoms.

Method

A systematic literature search was conducted using the databases Scopus, PsycINFO (OVID) and PubMed MEDLINE in December 2023 with a priori defined eligibility criteria. The literature search identified 1226 articles, of which eight met the eligibility criteria. Five studies exploring the effects of PE treatment on patients diagnosed with PTSD and suffering from comorbid psychotic experiences were included. Three studies containing follow-up data or secondary analysis on PTSD and psychotic symptoms from original studies fulfilling the inclusion and exclusion criteria were included. Each study was assessed for quality to estimate the risk of bias.

Results

Acknowledging the scarcity of available evidence, the results of the scoping review indicate that PE may be an effective treatment approach for reducing PTSD symptoms in patients with PTSD and comorbid psychotic symptoms. The reviewed studies found no iatrogenic effects, including no increase in psychotic symptoms.

Conclusion

PE appears to be a possibly effective PTSD treatment for patients suffering from PTSD and comorbid psychotic symptoms or disorders. However, the evidence is scarce, and larger confirmative trials are required for more conclusive evidence.

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长期暴露治疗创伤后应激障碍患者的精神症状：范围综述》。

背景：创伤是罹患精神病的一个重要风险因素。然而，由于担心会加重精神病症状，精神病通常被认为是不接受以创伤为重点的治疗的理由。长期暴露疗法（PE）是治疗严重创伤的一种公认有效的循证疗法：目的：评估现有的实证证据，以证明PE是治疗有精神病症状的患者创伤后应激障碍（PTSD）的可行治疗方案：方法：2023 年 12 月，我们使用 Scopus、PsycINFO (OVID) 和 PubMed MEDLINE 数据库进行了系统的文献检索，并事先确定了资格标准。文献检索发现了 1226 篇文章，其中 8 篇符合资格标准。其中有 5 项研究探讨了 PE 治疗对被诊断为创伤后应激障碍并伴有精神病性体验的患者的影响。另外还纳入了三项研究，这些研究包含了符合纳入和排除标准的原始研究中有关创伤后应激障碍和精神病症状的后续数据或二次分析。对每项研究进行了质量评估，以估计偏倚风险：尽管现有证据很少，但范围界定审查的结果表明，PE 可能是减少创伤后应激障碍和合并精神病症状患者创伤后应激障碍症状的一种有效治疗方法。综述研究未发现任何先天性影响，包括精神病症状的增加：对于患有创伤后应激障碍并合并精神病性症状或精神障碍的患者来说，PE 似乎是一种可能有效的创伤后应激障碍治疗方法。然而，这方面的证据并不多，需要进行更大规模的确证试验，以获得更多确凿证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical psychology & psychotherapy PSYCHOLOGY, CLINICAL-

CiteScore

6.30

自引率

5.60%

发文量

106

期刊介绍： Clinical Psychology & Psychotherapy aims to keep clinical psychologists and psychotherapists up to date with new developments in their fields. The Journal will provide an integrative impetus both between theory and practice and between different orientations within clinical psychology and psychotherapy. Clinical Psychology & Psychotherapy will be a forum in which practitioners can present their wealth of expertise and innovations in order to make these available to a wider audience. Equally, the Journal will contain reports from researchers who want to address a larger clinical audience with clinically relevant issues and clinically valid research.