Differential Effects of Comorbid Psychiatric Disorders on Treatment Outcome in Posttraumatic Stress Disorder from Childhood Trauma
Patients with posttraumatic stress disorder (PTSD) frequently have comorbid diagnoses such as major depressive disorder (MDD) and anxiety disorders (AD). Studies into the impact of these comorbidities on the outcome of PTSD treatment have yielded mixed results. The different treatments investigated...
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doaj-fb37a3ae213a4f15a60ee3d3254578842021-08-26T13:55:57ZengMDPI AGJournal of Clinical Medicine2077-03832021-08-01103708370810.3390/jcm10163708Differential Effects of Comorbid Psychiatric Disorders on Treatment Outcome in Posttraumatic Stress Disorder from Childhood TraumaNele Assmann0Eva Fassbinder1Anja Schaich2Christopher W. Lee3Katrina Boterhoven de Haan4Marleen Rijkeboer5Arnoud Arntz6Department of Psychiatry and Psychotherapy, Lübeck University, 23538 Lübeck, GermanyDepartment of Psychiatry and Psychotherapy, Lübeck University, 23538 Lübeck, GermanyDepartment of Psychiatry and Psychotherapy, Lübeck University, 23538 Lübeck, GermanyFaculty of Health and Medical Sciences, University of Western Australia, Perth, WA 6009, AustraliaFaculty of Health and Medical Sciences, University of Western Australia, Perth, WA 6009, AustraliaDepartment of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, 6200 MD Maastricht, The NetherlandsDepartment of Clinical Psychology, University of Amsterdam, 1000 GG Amsterdam, The NetherlandsPatients with posttraumatic stress disorder (PTSD) frequently have comorbid diagnoses such as major depressive disorder (MDD) and anxiety disorders (AD). Studies into the impact of these comorbidities on the outcome of PTSD treatment have yielded mixed results. The different treatments investigated in these studies might explain the varied outcome. The purpose of this study was to examine the impact of these comorbidities on the outcome of two specific PTSD treatments. MDD and AD were analyzed as predictors and moderators in a trial comparing 12 sessions of either eye movement desensitization and reprocessing (EMDR) or imagery rescripting (IR) in 155 adult patients with PTSD from childhood trauma. The primary outcome was reduction of PTSD symptoms (clinician-administered PTSD Scale for DSM-5, CAPS-5) assessed at eight-week follow-up and a secondary outcome was self-report PTSD symptoms (Impact of Event Scale, IES-R). MDD was not a predictor of treatment outcome but did have a significant moderator effect. Patients with MDD showed a better outcome if they were treated with IR, whereas patients without MDD improved more in the EMDR condition. No impact of AD emerged. It seems essential to consider comorbid MDD when planning PTSD treatment to improve treatment outcomes. More research is needed to replicate our findings and focus on different kinds of PTSD treatments and other comorbidities.https://www.mdpi.com/2077-0383/10/16/3708posttraumatic stress disorderdepressionanxiety disordertherapypredictionmoderator |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Nele Assmann Eva Fassbinder Anja Schaich Christopher W. Lee Katrina Boterhoven de Haan Marleen Rijkeboer Arnoud Arntz |
spellingShingle |
Nele Assmann Eva Fassbinder Anja Schaich Christopher W. Lee Katrina Boterhoven de Haan Marleen Rijkeboer Arnoud Arntz Differential Effects of Comorbid Psychiatric Disorders on Treatment Outcome in Posttraumatic Stress Disorder from Childhood Trauma Journal of Clinical Medicine posttraumatic stress disorder depression anxiety disorder therapy prediction moderator |
author_facet |
Nele Assmann Eva Fassbinder Anja Schaich Christopher W. Lee Katrina Boterhoven de Haan Marleen Rijkeboer Arnoud Arntz |
author_sort |
Nele Assmann |
title |
Differential Effects of Comorbid Psychiatric Disorders on Treatment Outcome in Posttraumatic Stress Disorder from Childhood Trauma |
title_short |
Differential Effects of Comorbid Psychiatric Disorders on Treatment Outcome in Posttraumatic Stress Disorder from Childhood Trauma |
title_full |
Differential Effects of Comorbid Psychiatric Disorders on Treatment Outcome in Posttraumatic Stress Disorder from Childhood Trauma |
title_fullStr |
Differential Effects of Comorbid Psychiatric Disorders on Treatment Outcome in Posttraumatic Stress Disorder from Childhood Trauma |
title_full_unstemmed |
Differential Effects of Comorbid Psychiatric Disorders on Treatment Outcome in Posttraumatic Stress Disorder from Childhood Trauma |
title_sort |
differential effects of comorbid psychiatric disorders on treatment outcome in posttraumatic stress disorder from childhood trauma |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-08-01 |
description |
Patients with posttraumatic stress disorder (PTSD) frequently have comorbid diagnoses such as major depressive disorder (MDD) and anxiety disorders (AD). Studies into the impact of these comorbidities on the outcome of PTSD treatment have yielded mixed results. The different treatments investigated in these studies might explain the varied outcome. The purpose of this study was to examine the impact of these comorbidities on the outcome of two specific PTSD treatments. MDD and AD were analyzed as predictors and moderators in a trial comparing 12 sessions of either eye movement desensitization and reprocessing (EMDR) or imagery rescripting (IR) in 155 adult patients with PTSD from childhood trauma. The primary outcome was reduction of PTSD symptoms (clinician-administered PTSD Scale for DSM-5, CAPS-5) assessed at eight-week follow-up and a secondary outcome was self-report PTSD symptoms (Impact of Event Scale, IES-R). MDD was not a predictor of treatment outcome but did have a significant moderator effect. Patients with MDD showed a better outcome if they were treated with IR, whereas patients without MDD improved more in the EMDR condition. No impact of AD emerged. It seems essential to consider comorbid MDD when planning PTSD treatment to improve treatment outcomes. More research is needed to replicate our findings and focus on different kinds of PTSD treatments and other comorbidities. |
topic |
posttraumatic stress disorder depression anxiety disorder therapy prediction moderator |
url |
https://www.mdpi.com/2077-0383/10/16/3708 |
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