P A J M de Bont1, D P G van den Berg2, B M van der Vleugel3, C de Roos4, A de Jongh5, M van der Gaag6, A M van Minnen7. 1. Mental Health Organization (MHO) GGZ Oost Brabant Land van Cuijk en Noord Limburg,Boxmeer,The Netherlands. 2. Parnassia Psychiatric Institute,Den Haag,The Netherlands. 3. Community Mental Health Service GGZ Noord-Holland Noord,Alkmaar,The Netherlands. 4. MHO Rivierduinen,Leiden,The Netherlands. 5. Department of Behavioral Sciences,Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam,Amsterdam,The Netherlands. 6. Department of Clinical Psychology,VU University Amsterdam and EMGO Institute for Health and Care Research,Van der Boechorststraat 1,BT Amsterdam,The Netherlands. 7. Radboud University Nijmegen, Behavioural Science Institute,NijCare,HE Nijmegen,The Netherlands.
Abstract
BACKGROUND: In patients with psychotic disorders, the effects of psychological post-traumatic stress disorder (PTSD) treatment on symptoms of psychosis, depression and social functioning are largely unknown METHOD: In a single-blind randomized controlled trial (RCT) 155 outpatients in treatment for psychosis (61.3% schizophrenic disorder, 29% schizoaffective disorder) were randomized to eight sessions prolonged exposure (PE; n = 53) or eye movement desensitization and reprocessing (EMDR) (n = 55), or a waiting-list condition (WL, n = 47) for treatment of their co-morbid PTSD. Measures were performed on (1) psychosis: severity of delusions (PSYRATS-DRS), paranoid thoughts (GPTS), auditory verbal hallucinations (PSYRATS-AHRS), and remission from psychotic disorder (SCI-SR-PANSS); (2) depression (BDI-II); (3) social functioning (PSP). Outcomes were compared at baseline, post-treatment, 6-month follow-up and over all data points. RESULTS: Both PE and EMDR were significantly associated with less severe paranoid thoughts post-treatment and at 6-month follow-up, and with more patients remitting from schizophrenia, at post-treatment (PE and EMDR) and over time (PE). Moreover, PE was significantly associated with a greater reduction of depression at post-treatment and at 6-month follow-up. Auditory verbal hallucinations and social functioning remained unchanged. CONCLUSIONS: In patients with chronic psychotic disorders PE andEMDR not only reduced PTSD symptoms, but also paranoid thoughts. Importantly, in PE and EMDR more patients accomplished the status of their psychotic disorder in remission. Clinically, these effects are highly relevant and provide empirical support to the notion that delivering PTSD treatment to patients with psychotic disorders and PTSD deserves increasing recognition and acceptance among clinicians.
RCT Entities:
BACKGROUND: In patients with psychotic disorders, the effects of psychological post-traumatic stress disorder (PTSD) treatment on symptoms of psychosis, depression and social functioning are largely unknown METHOD: In a single-blind randomized controlled trial (RCT) 155 outpatients in treatment for psychosis (61.3% schizophrenic disorder, 29% schizoaffective disorder) were randomized to eight sessions prolonged exposure (PE; n = 53) or eye movement desensitization and reprocessing (EMDR) (n = 55), or a waiting-list condition (WL, n = 47) for treatment of their co-morbid PTSD. Measures were performed on (1) psychosis: severity of delusions (PSYRATS-DRS), paranoid thoughts (GPTS), auditory verbal hallucinations (PSYRATS-AHRS), and remission from psychotic disorder (SCI-SR-PANSS); (2) depression (BDI-II); (3) social functioning (PSP). Outcomes were compared at baseline, post-treatment, 6-month follow-up and over all data points. RESULTS: Both PE and EMDR were significantly associated with less severe paranoid thoughts post-treatment and at 6-month follow-up, and with more patients remitting from schizophrenia, at post-treatment (PE and EMDR) and over time (PE). Moreover, PE was significantly associated with a greater reduction of depression at post-treatment and at 6-month follow-up. Auditory verbal hallucinations and social functioning remained unchanged. CONCLUSIONS: In patients with chronic psychotic disorders PE and EMDR not only reduced PTSD symptoms, but also paranoid thoughts. Importantly, in PE and EMDR more patients accomplished the status of their psychotic disorder in remission. Clinically, these effects are highly relevant and provide empirical support to the notion that delivering PTSD treatment to patients with psychotic disorders and PTSD deserves increasing recognition and acceptance among clinicians.
Entities:
Keywords:
Depression; PTSD; paranoia; psychosis; social functioning
Authors: Danessa Mayo; Sarah Corey; Leah H Kelly; Seghel Yohannes; Alyssa L Youngquist; Barbara K Stuart; Tara A Niendam; Rachel L Loewy Journal: Front Psychiatry Date: 2017-04-20 Impact factor: 4.157
Authors: Paul A J M de Bont; Berber M van der Vleugel; David P G van den Berg; Carlijn de Roos; Joran Lokkerbol; Filip Smit; Ad de Jongh; Mark van der Gaag; Agnes van Minnen Journal: Eur J Psychotraumatol Date: 2019-01-21
Authors: Suzy Johanna Martina Adriana Matthijssen; Ivo Heitland; Liselotte C M Verhoeven; Marcel A van den Hout Journal: Front Psychiatry Date: 2019-09-18 Impact factor: 4.157