The effectiveness of trauma-focused psychotherapy for complex post-traumatic stress disorder: A retrospective study.

Autor:	Melegkovits E; Traumatic Stress Clinic, Division of Psychiatry, University College London, London, United Kingdom.; Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, United Kingdom., Blumberg J; Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, United Kingdom., Dixon E; Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, United Kingdom., Ehntholt K; Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, United Kingdom., Gillard J; Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, United Kingdom., Kayal H; Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, United Kingdom., Kember T; Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, United Kingdom., Ottisova L; Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, United Kingdom., Walsh E; Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, United Kingdom., Wood M; Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, United Kingdom., Gafoor R; Research Department of Primary Care and Population Health, UCL, Royal Free Hospital, London, United Kingdom., Brewin C; Clinical, Educational and Health Psychology, University College London, London, United Kingdom., Billings J; Traumatic Stress Clinic, Division of Psychiatry, University College London, London, United Kingdom., Robertson M; Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, United Kingdom., Bloomfield M; Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, United Kingdom.; Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London, United Kingdom.; National Institute for Health Research University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom.; National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, United Kingdom.
Jazyk:	angličtina
Zdroj:	European psychiatry : the journal of the Association of European Psychiatrists [Eur Psychiatry] 2022 Nov 25; Vol. 66 (1), pp. e4. Date of Electronic Publication: 2022 Nov 25.
DOI:	10.1192/j.eurpsy.2022.2346
Abstrakt:	Objective: We retrospectively evaluated the effectiveness of trauma-focused psychotherapy (TF-P) versus stabilization and waiting in a civilian cohort of patients with an 11th version of the international classification of disease (ICD-11) diagnosis of complex post-traumatic stress disorder (CPTSD). Methods: We identified patients with CPTSD treated at a specialist trauma service over a 3-year period by triangulating evidence from self-report questionnaires, file review, and expert-clinician opinion. Patients completed a phase-based treatment: stabilization consisting of symptom management and establishing safety, followed by waiting for treatment (phase 1); individual TF-P in the form of trauma-focused cognitive behavioral therapy (TF-CBT), or eye movement desensitization and reprocessing (EMDR) or TF-CBT plus EMDR (phase 2). Our primary outcome was PTSD symptoms during phase 2 versus phase 1. Secondary outcomes included depressive symptoms, functional impairment, and a proxy CPTSD measure. Exploratory analysis compared outcomes between treatments. Adverse outcomes were recorded. Results: Fifty-nine patients were included. Compared to receiving only phase 1, patients completing TF-P showed statistically significant reductions in PTSD [ t (58) = -3.99, p  < 0.001], depressive symptoms [ t (58) = -4.41, p  < 0.001], functional impairment [ t (58) = -2.26, p  = 0.028], and proxy scores for CPTSD [ t (58) = 4.69, p  < 0.001]. There were no significant differences in outcomes between different treatments offered during phase 2. Baseline depressive symptoms were associated with higher PTSD symptoms and functional impairment. Conclusions: This study suggests that TF-P effectively improves symptoms of CPTSD. However, prospective research with validated measurements is necessary to evaluate current and new treatments and identify personal markers of treatment effectiveness for CPTSD.
Databáze:	MEDLINE
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