ABSTRACT

Background: Following promising effects of an intensive trauma treatment for adults, the question arises whether adolescents who suffer from severe post-traumatic stress disorder (PTSD) can also profit from a similar treatment programme.

Objective: To assess the effectiveness of an intensive trauma-focused treatment programme combining two evidence-based trauma-focused therapies and physical activities for adolescents suffering from severe PTSD.

Method: Treatment consisted of daily sessions of prolonged exposure (PE) therapy and eye movement desensitization and reprocessing (EMDR) therapy supplemented with physical activity (13 days on average). All patients (N = 27; 96.3% women, mean age = 16.1 years; SD = 1.3) had been exposed to one or more (interpersonal) traumatic events. Twenty-two of them (81.5%) also fulfilled the diagnostic criteria of a comorbid psychiatric disorder (mean number of comorbid disorders = 2.22). The majority of patients were referred because previous treatment was difficult or complications were expected to occur. Severity of PTSD symptoms and presence of a PTSD diagnostic status were assessed using the Dutch version of the CAPS-CA IV at baseline, post-treatment and at 3-month follow-up.

Results: CAPS-CA IV scores decreased significantly from pre- to post-treatment (Cohen’s d = 1.39). Of all patients 81.5% (n = 22) showed a clinically meaningful response, of whom 63% (n = 17) no longer fulfilled the diagnostic criteria of PTSD at post-treatment as established with the CAPS-CA IV. The results were maintained at 3-month follow-up. During treatment, neither adverse events nor dropout occurred.

Conclusions: The results suggest that an intensive trauma-focused treatment programme combining prolonged exposure, EMDR therapy, and physical activity can be an effective and safe treatment for adolescents suffering from severe PTSD and multiple comorbid psychiatric disorders.

摘要

背景：继对成人进行强化创伤治疗后，问题出现了，患有严重创伤后应激障碍 (PTSD) 的青少年是否也可以从类似的治疗计划中获益。

目的：评估强化创伤聚焦治疗方案结合两种循证创伤聚焦疗法和身体活动对患有严重 PTSD 的青少年的有效性。

方法: 治疗包括每天的长时间暴露 (PE) 疗法和眼动脱敏和再加工 (EMDR) 疗法，辅以身体活动（平均 13 天）。所有患者（N  = 27；96.3% 为女性，平均年龄 = 16.1 岁；SD = 1.3）都经历过一次或多次（人际）创伤事件。其中 22 人 (81.5%) 也符合共病精神障碍的诊断标准（平均共病数 = 2.22）。大多数患者被转诊是因为之前的治疗很困难或预计会发生并发症。在基线、治疗后和 3 个月的随访中，使用荷兰版的 CAPS-CA IV 评估了 PTSD 症状的严重程度和 PTSD 诊断状态的存在。

结果：CAPS-CA IV 评分从治疗前到治疗后显着下降（Cohen's d = 1.39）。在所有患者中，81.5% ( n  = 22) 显示出具有临床意义的反应，其中 63% ( n  = 17) 在治疗后不再符合 CAPS-CA IV 确定的 PTSD 诊断标准。结果保持在 3 个月的随访中。在治疗期间，既没有发生不良事件，也没有发生脱落。

结论：结果表明，结合长期暴露、EMDR 治疗和身体活动的以创伤为中心的强化治疗计划对于患有严重 PTSD 和多种共病精神障碍的青少年来说是一种有效且安全的治疗方法。