Impact of three variants of prolonged exposure therapy on comorbid diagnoses in patients with childhood abuse-related PTSD

Cogn Behav Ther. 2024 Jul;53(4):377-393. doi: 10.1080/16506073.2024.2318729. Epub 2024 Feb 27.

Abstract

Recent studies indicated that Prolonged Exposure (PE) is safe and effective for posttraumatic stress disorder (PTSD). It is unclear whether PE also leads to a reduction in comorbid diagnoses. Data from a large randomized controlled trial (N = 149) on the effects of three variants of PE for PTSD were used. We examined the treatment effects on co-morbid diagnoses of depressive, anxiety, obsessive compulsive, substance abuse, psychotic, eating and personality disorders in a sample of patients with PTSD related to childhood abuse. Outcomes were assessed with clinical interviews at baseline, post-treatment and at 6- and 12-month follow-up. All variants of PE led to a decrease from baseline to post-treatment in diagnoses of depressive, anxiety, substance use and personality disorders. Improvements were sustained during follow-up. We found an additional decrease in the number of patients that fulfilled the diagnostic criteria of a depressive disorder between 6- and 12-month follow-up. No significant changes were observed for the presence of OCD, psychotic and eating disorders. Findings suggest that it is effective to treat PTSD related to childhood abuse with trauma-focused treatments since our 14-to-16 weeks PE for PTSD resulted in reductions in comorbid diagnoses of depressive, anxiety, substance use and personality disorders.

Keywords: Prolonged exposure; anxiety; childhood-abuse related PTSD; comorbid diagnoses; depression; posttraumatic stress disorder.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Adult Survivors of Child Abuse / psychology
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / therapy
  • Child
  • Child Abuse / psychology
  • Comorbidity*
  • Depressive Disorder / complications
  • Depressive Disorder / epidemiology
  • Depressive Disorder / psychology
  • Depressive Disorder / therapy
  • Female
  • Humans
  • Implosive Therapy*
  • Male
  • Middle Aged
  • Stress Disorders, Post-Traumatic* / epidemiology
  • Stress Disorders, Post-Traumatic* / psychology
  • Stress Disorders, Post-Traumatic* / therapy
  • Substance-Related Disorders / complications
  • Substance-Related Disorders / therapy
  • Treatment Outcome

Grants and funding

The study is funded by ZonMW [WvD, Netherlands Health Research Council; Doelmatigheidsonderzoek #843001705] and Innovatiefonds Zorgverzekeraars [DACO, #3.180].