Trauma-Focused Treatment in Psychosis: A Systematic Review

IF 2.1 4区医学 Q3 PSYCHIATRY

Early Intervention in Psychiatry Pub Date : 2025-07-01 DOI:10.1111/eip.70064

I. Hellen, S. G. Døsvig, B. E. Liseth, N. Mørkved, J. O. Johannessen, E.-M. Løberg

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引用次数: 0

Abstract

Background

A majority of patients with psychosis have experienced trauma, but trauma-focused (TF) treatment is not routinely offered. The current systematic review set out to examine the effect of TF treatments in patients with a psychotic disorder and comorbid trauma symptoms on symptoms of (1) trauma, (2) psychosis and (3) anxiety, depression and psychosocial functioning.

Methods

A systematic search following the PRISMA guideline yielded 17 studies reported in 19 records.

Results

Overall, results indicated positive effects of TF treatment on trauma symptoms (87.5% of the studies), especially for TF CBT, EMDR and PE for psychosis, with indications of improvements to be stable over time. Positive outcomes were also reported for psychosis symptoms (72.2% of the studies). Results were inconclusive for depression (56% of the studies), anxiety (44.4% of the studies) and functioning (66.7% of the studies), which also were less frequently reported as outcomes in the included studies.

Discussion

The present findings give preliminary support for the effect of TF treatment on trauma and psychosis symptoms, but there is more uncertainty for anxiety, depression and psychosocial functioning, which need more research. Support was found for treatments delivered both individually and by group. The current evidence base on TF treatment in psychosis is, however, still at an early stage and is challenged by methodological issues.

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以创伤为重点的精神病治疗：系统综述

背景：大多数精神病患者都经历过创伤，但通常不提供以创伤为重点的治疗。目前的系统综述旨在研究TF治疗精神障碍和共病创伤症状患者对以下症状的影响：(1)创伤、(2)精神病和(3)焦虑、抑郁和社会心理功能。方法按照PRISMA指南进行系统检索，获得19篇文献报道的17篇研究。总体而言，结果表明TF治疗对创伤症状有积极作用（87.5%的研究），特别是对精神病的TF CBT、EMDR和PE治疗，随着时间的推移，有迹象表明改善是稳定的。精神病症状也报告了阳性结果（72.2%的研究）。在抑郁（56%的研究）、焦虑（44.4%的研究）和功能障碍（66.7%的研究）方面的结果尚无定论，这些结果在纳入的研究中也较少被报道。本研究结果初步支持了TF治疗对创伤和精神病症状的影响，但在焦虑、抑郁和心理社会功能方面存在更多不确定性，需要进一步研究。研究发现，个体治疗和群体治疗都得到了支持。然而，目前关于TF治疗精神病的证据基础仍处于早期阶段，并受到方法学问题的挑战。

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

Early Intervention in Psychiatry 医学-精神病学

CiteScore

4.80

自引率

5.00%

发文量

112

审稿时长

6-12 weeks

期刊介绍： Early Intervention in Psychiatry publishes original research articles and reviews dealing with the early recognition, diagnosis and treatment across the full range of mental and substance use disorders, as well as the underlying epidemiological, biological, psychological and social mechanisms that influence the onset and early course of these disorders. The journal provides comprehensive coverage of early intervention for the full range of psychiatric disorders and mental health problems, including schizophrenia and other psychoses, mood and anxiety disorders, substance use disorders, eating disorders and personality disorders. Papers in any of the following fields are considered: diagnostic issues, psychopathology, clinical epidemiology, biological mechanisms, treatments and other forms of intervention, clinical trials, health services and economic research and mental health policy. Special features are also published, including hypotheses, controversies and snapshots of innovative service models.