Abstract
Background: The effectiveness of the psychotherapeutic treatment of posttraumatic stress disorder is evidence-based and generally considered proven. However, the effectiveness of multimodal, group-based day clinic treatment programs has rarely been investigated. Moreover, there is no consensus in the literature concerning the question whether psychotherapeutic approaches for trauma-related disorders are also applicable for patients with complex PTSD (cPTSD). The aim of the study was to evaluate our multimodal group-based treatment program regarding a change of psychiatric burden, a change of protective factors, and possible differences in therapy outcome for patients with or without cPTSD.Methods: The group-based treatment for patients with trauma-related disorders was examined in 66 patients who filled out the following questionnaires in the first and in the last week of treatment: Essen Trauma Inventory (ETI), Screening for complex PTSD (SkPTBS), Patient Health Questionnaire—somatization module (PHQ-15), Beck Depression Inventory—Revised (BDI-II), Posttraumatic Growth Inventory (PTGI), and Questionnaire on social support (F-SozU).Results: The treatment was shown to significantly reduce depressive symptoms (p < 0.001, d = -0.536) and increase posttraumatic growth (New Possibilities: p = 0.004, d = 0.405; Personal Strength: p = 0.005, d = 0.414). For patients with cPTSD, depressive (p = 0.010, d = -0.63) as well as cPTSD symptoms (p = 0.020, d = -0.796) were significantly reduced; perceived social support was increased after day clinic treatment (p = 0.003, d = 0.61). Contrary to our expectations, somatoform symptoms were increased after therapy.Conclusions: The present work expands previous research by demonstrating that multimodal group-based, day clinic treatment is effective in the treatment of trauma-related disorders, also in their complex form.
Highlights
The prevalence of traumatic experiences throughout lifetime is high: in the US national comorbidity survey, 60.7% of men and 51.2% of women reported having experienced at least one traumatic event in their lifetime [1]
Of the 53 patients diagnosed with a posttraumatic stress disorder (PTSD), 22 were diagnosed with the appendix “complex.” The diagnosis of emotionally unstable personality disorder was given in five of the seven patients with the main diagnosis personality disorder
For patients with non-complex trauma-related disorders, we found a significant reduction of depressive symptoms (t = 2.989, df = 36, p = 0.005, d = -0.554, see Table 6) as well as a significant increase on two PTGI scales: New Possibilities (t = -3.117, df = 29, p = 0.004, d = 0.547) and Personal Strength
Summary
The prevalence of traumatic experiences throughout lifetime is high: in the US national comorbidity survey, 60.7% of men and 51.2% of women reported having experienced at least one traumatic event in their lifetime [1] Not all of these persons develop a psychiatric disease in the aftermath of trauma. In a nationwide representative German sample, the 1-month prevalence rate for PTSD in the whole population (irrespective of having been confronted with a traumatic event) was 1.5% and for complex PTSD (cPTSD) 0.5% [4]. For these persons, specialized treatment of trauma-related disorders is of utmost relevance. The aim of the study was to evaluate our multimodal groupbased treatment program regarding a change of psychiatric burden, a change of protective factors, and possible differences in therapy outcome for patients with or without cPTSD
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