Treating PTSD in Patients With Psychosis: A Within-Group Controlled Feasibility Study Examining the Efficacy and Safety of Evidence-Based PE and EMDR Protocols

Bont, Paul A. J. M. de; Minnen, Agnes van; Jongh, Ad de

doi:10.1016/j.beth.2013.07.002

Cited by 89 publications

(68 citation statements)

References 42 publications

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“…In a multiple baseline randomized controlled design, de Bont and colleagues [89••] found evidence for the feasibility, effectiveness, and safety of trauma-focussed treatments, including PE, in either past or present psychotic patients ( N = 10), with comparable effect sizes as in PTSD populations without psychosis. In addition, no treatment-related increases were found in hallucinations or delusions during or after PE.…”

Section: Psychosismentioning

confidence: 99%

See 1 more Smart Citation

Changes in Comorbid Conditions After Prolonged Exposure for PTSD: a Literature Review

Minnen

Zoellner

Harned

et al. 2015

Curr Psychiatry Rep

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108

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Prolonged exposure (PE) is an effective psychological treatment for patients who suffer from PTSD. The majority of PTSD patients have comorbid psychiatric disorders, and some clinicians are hesitant to use PE with comorbid patients because they believe that comorbid conditions may worsen during PE. In this article, we reviewed the evidence for this question: what are the effects of PE on comorbid symptoms and associated symptomatic features? We reviewed findings from 18 randomized controlled trials of PE that assessed the most common comorbid conditions (major depression, anxiety disorders, substance use disorders, personality disorders, and psychotic disorders) and additional symptomatic features (suicidality, dissociation, negative cognitions, negative emotions, and general health and work/social functioning). Although systematic research is not available for all comorbid populations, the existing research indicates that comorbid disorders and additional symptomatic features either decline along with the PTSD symptoms or do not change as a result of PE. Therefore, among the populations that have been studied to date, there is no empirical basis for excluding PTSD patients from PE due to fear of increases in comorbid conditions or additional symptomatic features. Limitations of the existing research and recommendations for future research are also discussed.

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Section: Psychosismentioning

confidence: 99%

“…In addition, one study evaluated the rate of suicidal behavior and non-suicidal self-injury during PE among five patients with comorbid PTSD and psychotic disorders [89••]. This study excluded patients with acute suicidality but included those with non-acute suicidal ideation.…”

Section: Suicidalitymentioning

confidence: 99%

Changes in Comorbid Conditions After Prolonged Exposure for PTSD: a Literature Review

Minnen

Zoellner

Harned

et al. 2015

Curr Psychiatry Rep

Self Cite

108

View full text Add to dashboard Cite

show abstract

“…Empirically supported treatments for PTSD predominantly include trauma-focused treatments that provide direct exposure to traumatic events in order to combat the role of avoidance in the maintenance of PTSD (8, 9). Findings suggest these traditional evidence-based treatments for trauma-related disorders can be safely and effectively employed to reduce symptoms of posttraumatic stress and chronic psychosis (3, 10–12); however, it remains unclear whether such treatments are appropriate for individuals with early psychosis (i.e., within the first 5 years of illness onset). The early stages of psychotic illness are a critical period for intervention.…”

Section: Introductionmentioning

confidence: 99%

Early Psychosis and Trauma-Related Disorders: Clinical Practice Guidelines and Future Directions

Cragin

Straus

Blacker³

et al. 2017

Front. Psychiatry

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Despite high rates of trauma-related disorders among individuals with early psychosis, no clinical practice guidelines for the treatment of comorbid early psychosis and trauma-related disorders exist to date. Indeed, the routine exclusion of individuals with past and current psychosis from participation in trauma research and practice has limited the accumulation of research that could support such clinical practice guidelines. While preliminary research evidence suggests that traditional, evidence-based treatments for trauma-related disorders can be safely and effectively employed to reduce symptoms of posttraumatic stress and chronic psychosis, it remains unclear whether such treatments are appropriate for individuals in the early stages of psychotic illness. Clinical experts (N = 118) representing 121 early psychosis programs across 28 states were surveyed using the expert consensus method. Forty-nine clinical experts responded and reached consensus on 46 of 49 expert consensus items related to the treatment of comorbid early psychosis and trauma-related disorders. Conjoint or family therapy and individual therapy were rated as treatment approaches of choice. Anxiety or stress management and psychoeducation were rated as treatment interventions of choice for addressing both trauma symptoms and psychotic symptoms. In addition, case management was rated as a treatment intervention of choice for addressing psychotic symptoms. No consensus was reached on expert consensus items regarding the appropriateness of a parallel treatment approach exposure interventions for addressing psychotic symptoms, or sensorimotor or movement interventions for addressing trauma symptoms. In areas where expert consensus exists and is supported by current research, preliminary clinical practice guidelines for the treatment of comorbid early psychosis and trauma-related disorders are offered. In areas where expert consensus does not exist, recommendations for future research are offered. The results of this study are intended to serve as a launching point for scientists and practitioners interested in advancing appropriate treatment for high-risk and underserved individuals with comorbid early psychosis and trauma-related disorders.

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“…While more research is needed on the appropriateness and effectiveness of existing PTSD treatments for patients with schizophrenia and whether adaptations or alternatives may be beneficial, evidence-based interventions for PTSD in patients with psychosis have demonstrated significant improvements in PTSD symptoms(de Bont et al, 2013; Frueh et al, 2009b; Mueser et al, 2008; van den Berg et al, 2015a), general mental health and depression symptoms(Frueh et al, 2009b; Mueser et al, 2008; Trappler et al, 2007), and self-reported functional improvements in interpersonal relationships(Frueh et al, 2009b). Moreover, one study demonstrated that frontline clinicians were able to successfully deliver evidence-based PTSD interventions to patients with SMI(Lu et al, 2012; Mueser et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Posttraumatic Stress Disorder Symptoms and Social and Occupational Functioning of People With Schizophrenia

Ng¹,

Petruzzi²,

Greene³

et al. 2016

J Nerv Ment Dis

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This study sought to clarify the contribution of PTSD to interpersonal and occupational functioning in people with schizophrenia. Self-report questionnaires and semi-structured interviews were employed to evaluate PTSD and brain injury, positive symptoms, depression, substance abuse, occupational and social functioning, and intelligence. Multiple regressions assessed the relationship between predictors and functional impairment. PTSD symptoms were present in 76% of participants, with 12% of participants meeting diagnostic criteria for PTSD. Participants with PTSD had higher rates of depression and more severe positive symptoms. Results of multiple regressions indicated that PTSD symptoms were the only significant predictor of patient-rated interpersonal and occupational functioning. PTSD symptoms were not associated with interviewer-rated interpersonal or occupational functioning or employment. While more research is needed, screening and treatment for exposure to traumatic events and PTSD symptoms might be indicated for individuals with schizophrenia. Availability of PTSD assessment and evidence-based treatments for people with schizophrenia is a crucial and often unmet health service need.

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Treating PTSD in Patients With Psychosis: A Within-Group Controlled Feasibility Study Examining the Efficacy and Safety of Evidence-Based PE and EMDR Protocols

Cited by 89 publications

References 42 publications

Changes in Comorbid Conditions After Prolonged Exposure for PTSD: a Literature Review

Changes in Comorbid Conditions After Prolonged Exposure for PTSD: a Literature Review

Early Psychosis and Trauma-Related Disorders: Clinical Practice Guidelines and Future Directions

Posttraumatic Stress Disorder Symptoms and Social and Occupational Functioning of People With Schizophrenia

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