在女性中同时治疗创伤后应激障碍和酒精使用障碍:一项随机临床试验
Anna Persson1, Åsa Axén2, Andrea Johansson Capusan2
1Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and The Stockholm Centre for Dependency Disorders, Stockholm, Sweden.
JAMA network open
|July 15, 2025
概括
综合治疗在患有酒精使用障碍 (AUD) 的女性中显著降低了PTSD症状. 虽然综合治疗和复发预防治疗都减少了酒精使用,但综合护理显示PTSD症状减少更大. 这突显了它在并发症疾病中的有效性.
科学领域:
- 临床心理学 临床心理学
- 成精神病学成精神病学
- 创伤研究 创伤研究
背景情况:
- 以创伤为重点的治疗方法对创伤后应激障碍 (PTSD) 有效,但在并发性物质使用障碍患者中未得到充分利用.
- 现有的研究表明,这些患者的患病率和治疗需求存在基于性别的差异,但临床试验中主要包括男性.
研究的目的:
- 评估综合创伤专注心理治疗的疗效,与女性酒精使用障碍 (AUD) 的常规复发预防相比.
主要方法:
- 一项随机临床试验,涉及90名女性,她们被诊断患有当前的PTSD和中度至重度AUD.
- 参与者被随机分配到12次综合治疗 (使用长期暴露 (COPE) 治疗PTSD和物质使用障碍的同时治疗) 或复发预防.
- 共同初级结局包括PTSD症状严重程度 (临床医生管理的DSM-5 PTSD尺度[CAPS-5]) 和每周的酒精使用,在9个月的随访期间进行评估.
主要成果:
- 综合治疗表明,与复发预防相比,PTSD症状严重程度的减少显著更大 (P=.02).
- 两种治疗手臂的每周酒精使用量随着时间的推移显著下降,综合治疗和复发预防之间没有可检测的差异.
- 在两组中,CAPS-5平均得分从基线下降到9个月的随访,综合治疗组的下降更为明显.
结论:
- 综合创伤集中治疗是一种安全有效的选择,可以减少AUD和持续饮酒的女性PTSD症状严重程度.
- 虽然综合治疗在解决PTSD症状方面表现出色,但复发预防也有效地减少了酒精使用,这表明结合或定制方法的潜在好处.
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