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Cognitive-Behavioural Therapy as a Preventive Treatment for Post Traumatic Stress Disorder

13. mai 2018 oppdatert av: Erik Andersson, Karolinska Institutet

Cognitive-Behavioural Therapy as a Preventive Treatment for Post Traumatic Stress Disorder: An Randomized Controlled Trial in the Acute Trauma Care

This study will examine the use of modified prolonged exposure therapy in trauma patients recently exposed to trauma in an emergency room to prevent the onset of post-traumatic stress disorder.

Studieoversikt

Detaljert beskrivelse

This study investigates if prolonged exposure is an effective treatment in reducing PTSD symptoms people who have recently experienced trauma. The study will also investigate predictive markers of PTSD, moderators of successful treatment and health economic aspects of the intervention.

Participants will first undergo an evaluation session that will include an interview (Immediate Stress Reaction Checklist) and questionnaires. Participants will subsequently be randomly assigned to receive either modified prolonged exposure therapy or attention control, starting the assigned intervention immediately. Participants in each arm will receive three weekly treatment sessions. Treatment will involve psychoeducation about common reactions to trauma, imaginal exposure (revisiting memories of a recent trauma out loud with a therapist and audio-recording these for review at home), exposure in vivo and breathing retraining. All participants will undergo assessments 2, 6 (primary endpoint) and 12 months after the intervention by blinded assessors. Patients unable to come to the clinic for follow-up assessments will be interviewed via telephone or skype. Source data will be quality monitored by an independent party (Karolinska trial alliance) according to the Helsinki Declaration.

Studietype

Intervensjonell

Registrering (Faktiske)

352

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

      • Stockholm, Sverige, 17177
        • Karolinska Institutet

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

16 år og eldre (Barn, Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  • Presenting to the emergency department at the Karolinska University hospital Solna in the past 72 hours before the intervention
  • Meets diagnostic criterion A for post-traumatic stress disorder in the fifth version of Diagnostic and Statistical Manual of Mental Disorders, DSM-5

Exclusion Criteria:

  • Do not want to participate in the study
  • Ongoing intoxication (e.g. severe alcohol intoxication)
  • Other serious psychiatric comorbidity that demands attention (e.g. manic episode, acute suicidal ideation)
  • Not oriented
  • Not having a memory ot the tramatic event

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Forebygging
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Modified prolonged exposure therapy
Participants will receive three sessions of modified prolonged exposure therapy.
Participants will receive three sessions of modified prolonged exposure therapy.
Placebo komparator: Attention control
Participants will receive three sessions of supportive counselling and psychoeducation
Participants will receive three sessions of supportive counselling and psychoeducation

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
CLINICIAN-ADMINISTERED PTSD SCALE for Diagnostic and Statistical Manual of Mental Disorders-5 (CAPS)
Tidsramme: Change 2-, 6- (primary endpoint) and 12 months after intervention
Clinical interview that gives a continuous measure of PTSD severity and dichotomous diagnosis of PTSD
Change 2-, 6- (primary endpoint) and 12 months after intervention

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-5 (PCL-5)
Tidsramme: Change 2-, 6- (primary endpoint) and 12 months after intervention
Self-report questionnaire for the assessment of PTSD severity
Change 2-, 6- (primary endpoint) and 12 months after intervention
Montgomery Åsberg Depression Rating Scale - Self-report (MADRS-S)
Tidsramme: Change from baseline to 2, 6 (primary endpoint) and 12 months after intervention
Self-report questionnaire for the assessment of severity of depression
Change from baseline to 2, 6 (primary endpoint) and 12 months after intervention
Euroqol (EQ-5D)
Tidsramme: Measured 6 months after intervention
Measure of general health and quality of life
Measured 6 months after intervention
WHO Disability Assessment Schedule (WHODAS)
Tidsramme: Change 2-, 6- (primary endpoint) and 12 months after intervention
Measure of general health and function
Change 2-, 6- (primary endpoint) and 12 months after intervention
Adverse events
Tidsramme: Change 2-, 6- (primary endpoint) and 12 months after intervention
Measure of number adverse events
Change 2-, 6- (primary endpoint) and 12 months after intervention
Subjective unit of distress scale (SUD)
Tidsramme: Change at week 1, week 2 and week 3
Ratings of distress
Change at week 1, week 2 and week 3
Intrusion diary
Tidsramme: Change at week 1, week 2 and week 3
A self-report diary on number of intrusions
Change at week 1, week 2 and week 3
Insomnia Severity Index (ISI)
Tidsramme: Change 2-, 6- (primary endpoint) and 12 months after intervention
Self-report questionnaire regarding insomnia
Change 2-, 6- (primary endpoint) and 12 months after intervention
Multidimensional Scale of Perceived Social Support (MSPSS)
Tidsramme: Change 2-, 6- (primary endpoint) and 12 months after intervention
A measure to assess for social support
Change 2-, 6- (primary endpoint) and 12 months after intervention
Trimbos Institute of costs in psychiatry (TIC-P)
Tidsramme: Measured at 6 (primary endpoint) months after the intervention
Self-report measure on societal costs
Measured at 6 (primary endpoint) months after the intervention

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

18. april 2017

Primær fullføring (Faktiske)

11. desember 2017

Studiet fullført (Faktiske)

11. desember 2017

Datoer for studieregistrering

Først innsendt

3. april 2017

Først innsendt som oppfylte QC-kriteriene

11. april 2017

Først lagt ut (Faktiske)

14. april 2017

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

17. mai 2018

Siste oppdatering sendt inn som oppfylte QC-kriteriene

13. mai 2018

Sist bekreftet

1. mai 2018

Mer informasjon

Begreper knyttet til denne studien

Andre studie-ID-numre

  • EPN 2015/1820-31

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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