The aim of the study is to explore the effects of two first choice PTSD treatments according to the guidelines, EMDR and prolonged exposure, in patients with a history of psychotic episodes.
ID
Source
Brief title
Condition
- Other condition
- Schizophrenia and other psychotic disorders
Synonym
Health condition
posttraumatische stresstoornis
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
• PTSD symptoms
•The frequency of PTSD-symptoms will be assessed with
Posttraumatic Stress Symptom Scale, Self Report, PSS- SR; Foa et
al.,1993; Dutch translation; Engelhard & Arntz, 2005; Questionnaire, 17 items).
• Psychotic symptoms
•Psychotic symptoms will be measured by the PSYRATS (Haddocok et
al., 1994, vert de Hert et al., 1996), which
measures the frequency and influence of hallucinations and
delusions.
Secondary outcome
1. Style of reasoning in psychotic patients, measured by the O-Life (mason,
1995;2006).
2. Level of functioning, measured by the Outcome Questionnaire (OQ; lambert &
Burlinganme, 2001).
3. Social functioning, measured by the Social Functioning Scale (van Birchwood,
1990.
4. Medication; changes
5. Number of admissions or crises during treatment
Background summary
Recent studies showed that PTSD treatment can be effective in patients with
severe psychopathology (such as borderline personality disorder, alcohol abuse,
dissociative disorders). In addition, no adverse treatment reactions, such as
symptom exacerbation or decompensation were found, despite the fears of some
therapists in the clinical field. In contrast, patients improved, both on PTSD
and on other symptoms.
Thusfar, little treatment studies have been conducted in patients with PTSD
who have shown psychotic episodes in their psychiatric history. This study will
exploratively study the effects of PTSD treatment in this population.
Study objective
The aim of the study is to explore the effects of two first choice PTSD
treatments according to the guidelines, EMDR and prolonged exposure, in
patients with a history of psychotic episodes.
Study design
A multiple baserate study consisting of 8 single cases will be performed.
After inclusion, patients are randomly devided to one of the two treatment
conditions, EMDR or prolonged exposure. The treatment will comprise 12 weeks.
Before and after and during the treatment sessions, psychopathological
symptoms, social behavior, endorsement, medication, medical consumption
behavior (crisis, admissions) will be monitored.
Intervention
Participants will be allocated to one of two treatment conditions, which are
active PTSD treatment programmes, aimed at processing of traumatic experiences,
EMDR and prolonged exposure. Both treatments are first choice treatment for
PTSD in several national and international guidelines for the treatment of
PTSD.
Study burden and risks
In clinical practice, some therapists may fear that PTSD treatment in
patients with comorbidity, due to the high emotional burden of the treatment,
will lead to an increase in PTSD symptoms, or/and an increase in the co-morbid
disorder. In contrast, a recent study showed that PTSD treatment was successful
in decreasing the PTSD symptoms and in decreasing the psychotic symptoms
(Mueser et al., 2007).
In clinical practice, therapists may fear to treat PTSD in other co-morbid
conditions as well. However, several studies have been conducted in
psychiatrically vulnerable populations, such as PTSD-patients with co-morbid
borderline personality disorders, alcohol abuse, and dissociative and
depressive symptoms and PTSD -patient who experienced sexual abuse in
childhood.
However, thusfar little studies in patients with psychotic disorders have been
conducted, and it can*t be predicted whether or not adverse reactions may
appear. Therefore, several precautions and safety procedures are in order, and
are included in the treatment study.
Loerangelsestraat 1a
5831 HA Boxmeer
NL
Loerangelsestraat 1a
5831 HA Boxmeer
NL
Listed location countries
Age
Inclusion criteria
1. Having had one or more psychotic episodes due to psychiatric illness (SCID-1; structured clinical interview for DSM-IV-diagnosis)
2. PTSD (CAPS: clinician-administered PTSD scale, originally by Blake, Weathers, Nagy, Kaloupek, Charney, & Keane, 1995)
Exclusion criteria
1. Severe dissociative disorders. High-scores on the SDQ-20 (scores above 35) are excluded because of the severe possibility of having a serious dissociative disorder. (somatoform-dissociation questionairre, 20 items; Nijenhuis, Spinhoven, Van Dyck, Van der Hart, & Vanderlinden, 1996),
2. Severe psychosis at the time of investigation (SCID-1)
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL24519.097.08 |