ГоловнаArchive of numbers2017Volume 25, issue 3 (92)A placebo-controlled study of the comparative efficacy of trauma-focused cognitive behavioral therapy and fluoxetine in children and adolescents affected with PTSD and symptoms of depression affected by the hybrid war in Eastern Ukraine
Title of the article A placebo-controlled study of the comparative efficacy of trauma-focused cognitive behavioral therapy and fluoxetine in children and adolescents affected with PTSD and symptoms of depression affected by the hybrid war in Eastern Ukraine
Authors Martsenkovskyi Igor
Year 2017 Issue Volume 25, issue 3 (92) Pages 44-48
Type of article Scientific article Index UDK 616.895:[616-085+615.851]::159.922.736:911.6 Index BBK -
Abstract High level of posttraumatic stress disorder (PTSD) symptoms overlaps with others, especially depressive and anxiety symptoms causes a high number of cases when there are grounds for a dual diagnosis of these disorders. CBT and SSRIs therapy is recommended for treatment of such conditions in adults. These recommendations can’t be transferred to pediatric practice without studying their eff ectiveness and safety. 117 children 14.2 ± 1.8 years old with PTSD and symptoms of depression after placebo run-in period were randomized to 16 weeks-long treatment in 3 groups: 1) fl uoxetine 20—40 mg; 2) TF-CBT (trauma-focused cognitivebehavioral therapy); 3) Placebo (brief psychosocial interventions, BPI) to compare their effi cacy and safety. We found that reducing the severity of PTSD symptoms was statistically signifi cant in both therapeutic groups (therapeutic eff ect of fl uoxetine — 12.35, 95 % CI — 10.92; 13.79; p < 0.05; therapeutic eff ect of TF-CBT — 12.15, 95 % CI — 10.82; 13.48; p < 0.05) versus placebo (therapeutic eff ect of BPI — 9.89 95 % CI — 8.86; 10.93). There was no statistically signifi cant diff erence in therapeutic effi cacy between fl uoxetine and TF-CBT (p > 0.05). Correlation analysis had found a direct relationship (r = 0.622, p < 0.01) in the group of fl uoxetine and inverse relationship (r = –0.637, p < 0.01) in the group of TF-CBT between the size of the therapeutic eff ect on CAPS-CA-5 and severity of depressive symptoms on the CDRS-R. Children with PTSD and clinically signifi cant comorbid depression versus children that had subclinical rates of depression were more sensitive to selective serotonin reuptake inhibitors treatment. Children and adolescents with the predominance of re-experiencing and avoidance symptoms had a greater sensitivity for TF-CBT.
Key words children, adolescents, hybrid war, posttraumatic stress disorder, depressive disorders, trauma-focused therapy, selective serotonin reuptake inhibitors
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