TY - JOUR
T1 - Impacto de los Trastornos de Personalidad Comórbidos en la psicoterapia para el Trastorno de Estrés Postraumático: Revisión Sistemática y Meta-análisis
AU - Snoek, Aishah
AU - Nederstigt, Jelle
AU - Ciharova, Marketa
AU - Sijbrandij, Marit
AU - Lok, Anja
AU - Cuijpers, Pim
AU - Thomaes, Kathleen
N1 - Funding Information: We thank Caroline Planting for her assistance in performing the systematic literature search. We also thank all authors who contributed their valuable data to this systematic review and meta-analysis. Finally, we are grateful to Stichting Steunfonds Joodse Geestelijke Gezondheidszorg for funding this work. Publisher Copyright: © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021
Y1 - 2021
N2 - 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 post-treatment (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.
AB - 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 post-treatment (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.
KW - PTSD
KW - comorbidity
KW - dropout
KW - personality disorder
KW - psychotherapy
KW - treatment response
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U2 - https://doi.org/10.1080/20008198.2021.1929753
DO - https://doi.org/10.1080/20008198.2021.1929753
M3 - Review article
C2 - 34211638
SN - 2000-8198
VL - 12
JO - European journal of psychotraumatology
JF - European journal of psychotraumatology
IS - 1
M1 - 1929753
ER -