实用性随机对照试验指导自助与个人认知行为疗法,以创伤为焦点,治疗创伤后应激障碍 (RAPID)
Jonathan I Bisson1, Cono Ariti2, Katherine Cullen3
1Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK.
Health technology assessment (Winchester, England)
|November 20, 2023
概括
使用Spring的指导自助是一种可行的,具有成本效益的治疗创伤后应激障碍 (PTSD). 它与传统疗法一样有效,为患有单一事件创伤的患者提供了一种节省时间的选择.
科学领域:
- 心理健康 心理健康
- 精神病学是一个精神病学.
- 临床心理学 临床心理学
背景情况:
- 引导自助 (GSH) 对于各种心理健康状况是有效的.
- 格萨斯医院 (GSH) 为创伤后应激障碍 (PTSD) 提供了一种时间效率高且易于获得的治疗方法.
- 这种方法有可能减少治疗等待时间和医疗费用.
研究的目的:
- 为了确定以创伤为重点的指导自助 (GSH) 是否与轻度至中度PTSD的个人面对面认知行为疗法 (CBT) 不逊色.
- 该研究旨在评估与传统CBT相比,GSH的成本效益.
- 嵌套过程评估检查了忠实性,坚持性和影响结果的因素.
主要方法:
- 进行了一项多中心实用随机对照非劣势试验.
- 196名患有轻度至中度PTSD的成年人被随机 (1:1) 分给GSH (使用春季计划) 或面对面的CBT.
- 首要结局是在16周使用临床医生管理的PTSD尺度 (CAPS-5) 测量;次要结局包括52周的症状严重程度,功能和并发性症状.
主要成果:
- 在CAPS-5的16周内,GSH在CBT上表现出非劣势性 (平均差异为1.01,p=0.012).
- 在52周后,改善得到维持,尽管非劣势结果是不确定的 (p=0.15).
- 提供GSH的成本显著降低 (277英 vs. 729英),耐受性良好,质量调整后寿命年数没有显著差异.
结论:
- 使用春季计划以创伤为重点的指导自我帮助与单个面对面的CBT相比,对于从单一创伤事件中轻度到中度的PTSD来说是不劣的.
- 在这种患者群体中,GSH应被视为一线治疗选择.
- 需要进行进一步的研究,以确定GSH大规模传播和实施的最佳方法.
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