认知暴露疗法治疗创伤后应激障碍的5年随访

The effect of cognitive-exposure therapy on posttraumatic stress disorder:a five-year follow up

目的:探讨5年随访时认知暴露治疗对创伤后应激障碍(PTSD)患者的效果。方法:63例PTSD患者随机分为两组,分别进行药物治疗和心理治疗,并且在治疗前、治疗后、治疗后3个月、治疗后5年进行心理状况评定。结果:重复测量的方差分析表明,在创伤后应激障碍症状清单量表(PCLS)、症状自评量表、贝克抑郁问卷、汉米尔顿抑郁量表、状态-特质焦虑问卷及汉米尔顿焦虑量表上,总体上组间(药物和心理治疗)效应不显著(F=3.111,P>0.05),时间(重复变量)效应显著(F=9.011,P<0.01)。治疗后心理治疗组PCLS再经历和回避分比药物治疗组下降更显著。结论:认知暴露治疗和药物治疗对PTSD患者疗效相近,认知暴露治疗对再经历症状和回避症状疗效更好。

Objective： To explore the effect of cognitive-exposure therapy on PTSD （ posttraumatie stress disorder） patients after 5 years. Method ：63 PTSD patients were divided randomly into two groups：medica- tion group and psychological therapy group, and assessed psychologically before treatment ,just after treatment, at the 3rd month after treatment, at the 5th year after treatment. Results：Repeated measure variance analysis showed no main between - group effect on PCLS （posttraumatic stress disorder diecklist scale）, SCL-90, BDI, HAMD, STAI and HAMA score （F = 3.111, P 〉 0.05 ）, but showed pre-post treatment main effect （F = 9. 011, P 〈0.01 ）. The re-experience and avoidance score decreased more in the psychological therapy group than the medication group after thetreatment. Conclusion：Cognitive-exposure therapy is similar in total curative effect and superior in improving re-experience and avoidance to medication in treatment of patients with PTSD.