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Impact of comorbid personality disorders on psychotherapy for post-traumatic stress disorder: systematic review and meta-analysis
European Journal of Psychotraumatology ( IF 5.783 ) Pub Date : 2021-06-22 , DOI: 10.1080/20008198.2021.1929753
Aishah Snoek 1, 2 , Jelle Nederstigt 2 , Marketa Ciharova 3 , Marit Sijbrandij 3 , Anja Lok 4 , Pim Cuijpers 3 , Kathleen Thomaes 1, 2
Affiliation  

ABSTRACT

Background: Although personality disorders are common in PTSD patients, it remains unclear to what extent this comorbidity affects PTSD treatment outcome.

Objective: This constitutes the first meta-analysis investigating whether patients with and without comorbid personality disorders can equally benefit from psychotherapy for PTSD.

Method: A systematic literature search was conducted in PubMed, EMBASE, PsychINFO and Cochrane databases from inception through 31 January 2020, to identify clinical trials examining psychotherapies for PTSD in PTSD patients with and without comorbid personality disorders (PROSPERO reference CRD42020156472).

Results: Of the 1830 studies identified, 12 studies reporting on 918 patients were included. Effect sizes were synthesized using a random-effects model. Patients with comorbid personality disorders did not have significantly higher baseline PTSD severity (Hedges’ g = 0.23, 95%CI −0.09–0.55, p = .140), nor were at higher risk for dropout from PTSD treatment (RR = 1.19, 95%CI 0.83–1.72, p = .297). Whilst pre- to post-treatment PTSD symptom improvements were large in patients with comorbid PDs (Hedges’ g = 1.31, 95%CI 0.89–1.74, p < .001) as well as in patients without comorbid PDs (Hedges’ g = 1.57, 95%CI 1.08–2.07, p < .001), personality disorders were associated with a significantly smaller symptom improvement at post-treatment (Hedges’ g = 0.22, 95%CI 0.05–0.38, p = .010).

Conclusion: Although the presence of personality disorders does not preclude a good treatment response, patients with comorbid personality disorders might benefit less from PTSD treatment than patients without comorbid personality disorders.



中文翻译:

共病人格障碍对创伤后应激障碍心理治疗的影响:系统回顾和荟萃分析

摘要

背景:虽然人格障碍在 PTSD 患者中很常见,但尚不清楚这种合并症在多大程度上影响 PTSD 治疗结果。

目的:这是第一项调查患有和不患有共病人格障碍的患者是否可以同样受益于 PTSD 心理治疗的荟萃分析。

方法:从开始到 2020 年 1 月 31 日,在 PubMed、EMBASE、PsychINFO 和 Cochrane 数据库中进行了系统的文献检索,以确定在伴有和不伴有人格障碍的 PTSD 患者中检查 PTSD 心理治疗的临床试验(PROSPERO 参考 CRD42020156472)。

结果:在确定的 1830 项研究中,包括 12 项报告了 918 名患者的研究。使用随机效应模型合成效应大小。患有共病人格障碍的患者没有显着更高的基线 PTSD 严重程度(Hedges' g = 0.23, 95%CI -0.09–0.55, p = .140),也没有更高的 PTSD 治疗退出风险(RR = 1.19, 95 %CI 0.83–1.72,p = .297)。虽然治疗前后 PTSD 症状改善在伴有共病 PD 的患者 (Hedges' g = 1.31, 95%CI 0.89–1.74, p < .001) 以及没有共病 PD 的患者 (Hedges' g = 1.57 , 95%CI 1.08–2.07, p< .001),人格障碍与治疗后明显较小的症状改善相关(Hedges' g = 0.22,95%CI 0.05–0.38,p = .010)。

结论:虽然人格障碍的存在并不排除良好的治疗反应,但与没有并存人格障碍的患者相比,患有并存人格障碍的患者从 PTSD 治疗中获益可能更少。

更新日期:2021-06-22
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