[创伤集中和人格障碍治疗创伤后应激障碍和共病型C型人格障碍]。

Q4 Medicine
Tijdschrift voor psychiatrie Pub Date : 2025-01-01
A van den End, A T F Beekman, J J M Dekker, K Thomaes
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引用次数: 0

摘要

背景:创伤后应激障碍(PTSD)与回避型、依赖型和强迫性人格障碍(C-PD)的高发相关。目前尚不清楚同时治疗创伤后应激障碍和共病簇C-PD是否比单独治疗创伤更有效。目的:观察加组52 ~ 58次PD治疗的疗效;GST)到12-18次以创伤为重点的个人治疗(图像改写;imr)。方法:将130例成人门诊患者随机分为ImRs组和ImRs+GST组。主要结局是治疗开始一年后PTSD的严重程度(CAPS-5)。次要结局是C-PD组、精神症状、生活质量、功能、治疗反应、缓解和辍学。结果:在12个月时,创伤后应激障碍严重程度(d = 2,4)、PD症状和所有其他次要结局均大幅下降。不同条件之间没有显著差异。结论:两组疗效均显著。结果提示,创伤为重点的治疗是PTSD合并簇C-PD患者首选的主要治疗方法,在存在人格障碍残留症状的情况下,可考虑针对人格障碍进行更强化的心理治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Trauma-focused and personality disorder treatment for posttraumatic stress disorder and comorbid cluster C personality disorder].

Background: Posttraumatic stress disorder (PTSD) is associated with high rates of avoidant, dependent and obsessive-compulsive personality disorders (cluster C-PD). It is unknown whether concurrent treatment for PTSD and comorbid cluster C-PD leads to superior treatment effects, compared to standalone trauma-focused treatment.

Aim: To test the efficacy of adding 52-58 sessions of PD treatment (group schema therapy; GST) to 12-18 sessions of individual trauma-focused treatment (imagery rescripting; ImRs).

Method: 130 adult outpatients were randomized to receive either ImRs or ImRs+GST. The main outcome was PTSD severity one year after start of treatment (CAPS-5). Secondary outcomes were cluster C-PD, psychiatric symptoms, quality of life, functioning, treatment response, remission, and dropout.

Results: At 12 months, there were large decreases in PTSD severity (d = 2,4), PD symptoms and all other secondary outcomes. There were no significant differences between conditions.

Conclusion: Large effects were observed in both treatment arms. The results suggests that trauma focused treatment is the preferred primary treatment in patients presenting with PTSD and comorbid cluster C-PD, after which more intensive psychotherapy aimed at the personality disorder may be considered in the case of residual personality disorder symptoms.

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来源期刊
Tijdschrift voor psychiatrie
Tijdschrift voor psychiatrie Medicine-Medicine (all)
CiteScore
0.60
自引率
0.00%
发文量
118
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