动手身心疗法对丹麦退伍军人创伤后应激障碍的影响:随机临床试验

Susan Andersen PhD, Henrik Steen Andersen MedSc, Hannah Ahrensberg MSc, Ioana Lazar MSc, Tine Tjørnhøj-Thomsen, Nanna Gram Ahlmark PhD
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摘要

创伤后应激障碍(PTSD)影响着许多退伍军人。由于传统治疗方法效果有限且存在障碍,人们越来越关注身心治疗方法。然而,几乎没有证据表明这些方法是否有治疗创伤应激障碍的潜力。本研究的目的是比较为期 6 个月的实践身心疗法作为常规治疗(TAU)的附加疗法与单独使用 TAU 的效果。因服兵役而患有创伤后应激障碍的参与者被随机分配到干预组或常规治疗(TAU)组。干预组在6个月内接受24次动手操作身心疗法,作为TAU的附加疗法。主要结果是 6 个月(干预后)时的创伤后应激障碍检查表-军事版(PCL-M)。结果测量在四个时间点进行:基线、3 个月(中途)、6 个月(干预后)和 12 个月(随访)。意向治疗分析在分配时进行。共有 42 名参与者被随机分配(22 名对照组,20 名干预组)。干预组中有两人中断了身心疗法。干预后,接受过身心疗法的参与者创伤后应激障碍的严重程度明显减轻(PCL-M 评分在组间的平均差异为-11.1,95% C-0):-11.1,95% CI -17.9 to -4.2,p = 0.002,效应大小 d = 1.06)。随访时,PCL-M评分在组间无统计学意义(组间差异:-4.65,95% CI -11.8至1.50)。事后分析表明,从基线到随访,干预组缓解创伤后应激障碍的人数为 25%,对照组为 0%。我们的研究表明,为期6个月的实践身心疗法能显著减少创伤后应激障碍症状。在干预期结束 6 个月后,症状的大幅减轻并未得到维持。有必要对身心疗法作为创伤后应激障碍的辅助治疗方法进行进一步研究。
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Effects of hands-on mind-body therapy on posttraumatic stress disorder among Danish military veterans: A randomized clinical trial

Posttraumatic stress disorder (PTSD) affects many military veterans. Given limited success of and barriers to conventional treatments, increasing interest is being paid to mind-body therapy approaches. However, little evidence exists on whether these have the potential to treat traumatic stress. The aim of this study was to compare 6 months of hands-on mind-body therapy as an add-on to treatment as usual (TAU) with TAU alone. Participants with PTSD resulting from active military service were randomly assigned to the intervention group or treatment-as-usual (TAU) group. The intervention group received 24 hands-on manipulative mind-body therapy sessions during 6 months as add-on to TAU. The primary outcome was the PTSD Checklist-Military version (PCL-M) at 6 months (postintervention). Outcome measurements were obtained at four time points; baseline, 3 months (midway), 6 months (postintervention), and 12 months (follow-up). Intention-to-treat analysis was done masked to allocation. A total of 42 participants were randomized (22 control, 20 intervention). In the intervention group, two discontinued the mind-body therapy. At postintervention, participants who had received mind-body treatment demonstrated greater reduction in PTSD severity (PCL-M scores between-group mean difference: −11.1, 95% CI −17.9 to −4.2, p = 0.002, effect size d = 1.06). At follow-up, PCL-M scores were not statistically significant between groups (between-group difference: −4.65, 95% CI −11.8 to 1.50). Post hoc analysis showed that number of participants remitting from PTSD from baseline to follow-up was 25% in the intervention group and 0% in the control group. Our study showed that hands-on mind-body therapy over 6 months produced clinically significant decrease in PTSD symptoms. The large reduction in symptoms was not maintained 6 months after the intervention period. Further research on mind-body therapy as adjunctive PTSD treatment is warranted.

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