Treating Posttraumatic Stress Disorder in Patients with Opioid Use Disorder

治疗阿片类药物使用障碍患者的创伤后应激障碍

• 批准号: 10247656
• 负责人: Kelly R. Peck
• 金额: $ 18.52万
• 依托单位: UNIVERSITY OF VERMONT & ST AGRIC COLLEGE
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-15 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10247656
• 关键词: Abstinence; Adult; Anxiety; Attenuated; Behavior; Centers of Research Excellence; Clinical; Cognitive Therapy; Diagnosis; Dose; Drug usage; Ensure; Health; Health Resources; Incentives; Individual; Intake; Mental Depression; Mental Health; Outcome; Participant; Patients; Population; Post-Traumatic Stress Disorders; Prevalence; Procedures; Randomized; Reporting; Research Design; Severities; Symptoms; Training; Treatment outcome; Vermont; adherence rate; buprenorphine treatment; clinically relevant; craving; financial incentive; illicit opioid; methadone treatment; opioid agonist therapy; opioid use disorder; psychopharmacologic; psychosocial; randomized trial; symptomatology; therapy adherence; trauma exposure; treatment as usual

Among patients with opioid use disorder (OUD), 90% report lifetime trauma exposure and 33% meet criteria for posttraumatic stress disorder (PTSD). The co-occurrence of OUD and PTSD is associated with more severe mental health symptoms and worse opioid agonist treatment (OAT) outcomes relative to either diagnosis alone. Prolonged exposure therapy (PET) is an efficacious manualized cognitive-behavioral treatment for reducing PTSD severity. Although preliminary findings indicate that PET may reduce PTSD symptom severity among patients receiving treatment for concomitant OUD, it is unclear to what extent observed improvements were a function of PET versus the psychopharmacological effects of OAT itself. Therefore, the question of whether OAT alone may attenuate PTSD symptomatology in the absence of intensive cognitive-behavioral therapy remains unanswered and is important given the prevalence and deleterious effects of PTSD among OAT patients, as well as the ever-present constraints on mental health resources in SUD treatment settings.

在阿片类药物使用障碍（OUD）的患者中，有90％的人报告终生创伤和33％ 创伤后应激障碍（PTSD）的标准。 Oud和PTSD的共发生与更多 严重的心理健康症状和相对于任何一种诊断 独自的。长时间暴露疗法（PET）是一种有效的手动认知行为治疗 减少PTSD的严重性。尽管初步发现表明PET可能会减轻PTSD症状严重程度 在接受伴随OUD治疗的患者中，尚不清楚观察到的改善程度如何 是宠物与燕麦本身的心理药理作用的函数。因此， 在没有密集的认知行为的情况下，仅燕麦是否可以减弱PTSD症状 鉴于PTSD在OAT中的流行和有害影响，治疗仍然没有解决，很重要 患者以及在SUD治疗环境中对心理健康资源的限制。