情绪意识和表达疗法与老年退伍军人的慢性疼痛认知行为疗法:一项随机临床试验
Brandon C Yarns1,2, Nicholas J Jackson3, Alexander Alas1
1Department of Mental Health, VA Greater Los Angeles Healthcare System, California.
JAMA network open
|June 13, 2024
概括
情绪意识和表达疗法 (EAET) 在减少老年退伍军人的慢性疼痛严重程度方面显著超过认知行为疗法 (CBT). EAET还改善了焦虑,抑郁和PTSD症状,提供了更有效的心理干预.
科学领域:
- 老年医学 老年医学
- 心理学 心理学 心理学
- 疼痛管理 疼痛管理
背景情况:
- 慢性疼痛在老年人中普遍存在并使人失去能力,需要有效的心理干预.
- 认知行为疗法 (CBT) 是目前的标准,对于慢性疼痛只能提供适度的益处.
- 需要更有效的治疗方案来管理老年人群的慢性疼痛.
研究的目的:
- 为了比较情绪意识和表达疗法 (EAET) 与老年男性退伍军人慢性疼痛的CBT的疗效.
- 调查抑郁症,焦虑症或PTSD的基线水平是否适度对EAET的治疗反应.
主要方法:
- 一个双臂随机临床试验,涉及126名老年退伍军人 (60-95岁) 患有慢性肌肉骨疼痛.
- 参与者接受EAET或CBT,每个包括一个个人和八个小组会议.
- 主要结局是从基线到6个月的随访期间,通过简要疼痛清单测量疼痛的严重程度.
主要成果:
- 与CBT相比,EAET在治疗后和6个月的随访期间都显示出优异的疼痛严重程度降低 (分别P < .001和P = .01).
- 显著更高的EAET参与者的百分比实现了临床显著的疼痛减轻 (63%对17%,P<.001).
- 与CBT相比,EAET还显示了焦虑,抑郁,PTSD症状,生活满意度和治疗满意度的更大改善.
结论:
- 对于老老兵的慢性疼痛,EAET似乎比CBT更有效的干预措施,特别是那些同时出现心理痛苦的人.
- 这些发现表明,EAET原则可以整合到主流疼痛管理中,以改善复杂患者群体的治疗结果.
- 较高的基线抑郁,焦虑和PTSD症状预测了EAET更大的疼痛减轻,突出了其向的好处.
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