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 posttreatment (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.
Impacto de los Trastornos de Personalidad Comórbidos en la psicoterapia para el Trastorno de Estrés Postraumático: Revisión Sistemática y Meta-análisisAntecedentes: Aunque los trastornos de la personalidad son comunes en los pacientes con TEPT, sigue sin estar claro en qué medida afecta esta comorbilidad al resultado del tratamiento del TEPT. Objetivo: Este constituye el primer meta-análisis que investiga si los pacientes con ysin trastornos de la personalidad comórbidos pueden beneficiarse de la misma forma de la psicoterapia para el TEPT. Método: Se realizó una búsqueda sistemática de literatura en las bases de datos PubMed, EMBASE, PsycINFO yCochrane desde su creación hasta el 31 de enero de 2020, para identificar estudios clínicos que examinaron psicoterapias para el TEPT en pacientes con TEPT, con ysin trastornos de la personalidad comórbidos. (referencia PROSPERO CRD42020156472). Resultados: De los 1830 estudios identificados, se incluyeron 12 estudios, que reportaron 918 pacientes. Los tamaños de efecto fueron sintetizados usando un modelo de efectos aleatorios. Los pacientes con trastornos de la personalidad comórbidos no tuvieron una severidad del TEPT basal significativamente mayor (gde Hedges = 0.23, IC 95% -0.09 -0.55, p= .140), ni tuvieron un mayor riesgo de abandono del tratamiento del TEPT (RR=1.19, p= .297). Mientras que la mejoría de los síntomas de TEPT pre ...
