在强烈强迫症治疗中同时发生的PTSD:对治疗轨迹的影响与反应的影响
Caitlin M Pinciotti1, Nathaniel Van Kirk2, Gregor Horvath3
1Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
Journal of affective disorders
|March 7, 2024
概括
强迫症 (OCD) 与同时发生的创伤后应激障碍 (PTSD) 可能需要量身定制的认知行为治疗 (CBT) 与暴露和响应预防 (ERP). 特定的症状,如不可接受的想法和对称性,可能需要以创伤为重点的干预措施,以获得更好的结果.
科学领域:
- 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:
- 强迫症 (OCD) 和同时出现的创伤后应激障碍 (PTSD) 与更严重和慢性强迫症表现有关.
- 对这种并发症的认知行为治疗 (CBT) 与暴露和响应预防 (ERP) 的治疗有效性显示出混合的结果.
- 了解患有同时出现PTSD的个体对强迫症治疗的障碍,对于确定独特的治疗需求至关重要.
研究的目的:
- 为了比较强迫症患者的治疗反应和治疗轨迹,与患有强迫症和同时发生的PTSD,接受强化CBT与ERP的患者进行比较.
- 在强迫症中识别特定的症状维度,当PTSD存在时,对标准CBT与ERP的反应较弱.
主要方法:
- 在接受强迫症治疗的大量患者中使用线性回归和潜增长曲线分析.
- 对强迫症患者 (n=3083) 和强迫症+PTSD患者 (n=191) 的治疗结果进行比较.
主要成果:
- 患有强迫症+PTSD的患者需要显著增加治疗日数 (约11天),以实现强迫症整体严重程度的可比降低.
- 患有强迫症和创伤后应激障碍的人对特定症状维度的治疗反应较差,特别是不可接受的想法和对称性症状.
- 对不可接受的想法的影响是适度的,这表明这些症状与PTSD之间有很强的联系.
结论:
- 对强烈强迫症治疗的一种适合所有人的方法可能对同时出现PTSD的患者来说不足.
- 广泛的结果措施可能无法捕捉与创伤相交的症状维度中的治疗收益.
- 在强迫症+PTSD中,不可接受的想法和对称症状可能需要在标准治疗方案内进行综合创伤专注干预.
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