在接受基于证据的治疗中治疗创伤后应激障碍的退伍军人中存在自杀风险
Kevin G Saulnier1,2,3, Stuart Brabbs1, Benjamin R Szymanski1
1Serious Mental Illness Treatment Resource and Evaluation Center, Office of Mental Health, Department of Veterans Affairs, Ann Arbor, Michigan.
JAMA network open
|December 26, 2024
概括
对创伤后应激障碍 (PTSD) 进行基于证据的心理治疗显著降低了退伍军人的自杀风险. 然而,完成8个或更多的会议并没有显示出额外的自杀预防益处.
科学领域:
- 心理健康 心理健康
- 公共卫生 公共卫生
- 退伍军人事务 退伍军人事务
背景情况:
- 患有创伤后应激障碍 (PTSD) 的退伍军人自杀率较高.
- 了解治疗对自杀风险的影响对于退伍军人卫生管理局 (VHA) 的运作至关重要.
研究的目的:
- 评估被诊断患有PTSD的退伍军人中自杀风险,他们启动或完成了基于证据的心理治疗 (认知处理疗法或长期暴露[CPT/PE]).
主要方法:
- 一项队列研究分析了2016-2019年期间被诊断患有PTSD的美国退伍军人到2020年的自杀风险.
- 数据包括VHA护理记录和死亡证明信息.
- 多变量比例风险回归模型自杀风险基于CPT/PE启动和完成.
主要成果:
- 与非启动相比,启动CPT/PE与23%的自杀风险降低有关.
- 接受适当的课程 (≥8次CPT/PE课程) 并没有显着与较低的自杀风险相关.
- 这些发现甚至在分析接受任何心理治疗的退伍军人时也是如此.
结论:
- 开始CPT/PE治疗与VHA系统内新诊断的PTSD退伍军人的自杀风险降低有关.
- 虽然启动是有益的,但会议数量 (≥8) 没有提供额外的自杀风险降低.
- 进一步的研究可能会探索最佳的治疗持续时间和预防自杀的方法.
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