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标题：Glucocorticoid augmentation of prolonged exposure therapy: rationale and case report
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作者：Rachel Yehuda ; Linda M. Bierer ; Laura Pratchett 等
期刊名称：European Journal of Psychotraumatology
印刷版ISSN：2000-8198
电子版ISSN：2000-8066
出版年度：2010
卷号：1
DOI：10.3402/ejpt.v1i0.5643
语种：English
出版社：Taylor & Francis Group
摘要：Rationale: Prolonged exposure (PE) therapy has been found to reduce symptoms of posttraumatic stress disorder (PTSD); however, it is difficult for many patients to engage fully in the obligatory retelling of their traumatic experiences. This problem is compounded by the fact that habituation and cognitive restructuring the main mechanisms through which PE is hypothesized to work are not instantaneous processes, and often require several weeks before the distress associated with imaginal exposure abates. Case reports: Two cases are described that respectively illustrate the use of hydrocortisone and placebo, in combination with PE, for the treatment of combat-related PTSD. Based on known effects of glucocorticoids on learning and memory performance, we hypothesized that augmentation with hydrocortisone would improve the therapeutic effects of PE by hastening ‘‘new’’ learning and facilitating decreases in the emotional impact of fear memories during the course of treatment. The veteran receiving hydrocortisone augmentation of PE displayed an accelerated and ultimately greater decline in PTSD symptoms than the veteran receiving placebo. Conclusions: While no general conclusion can be derived from comparison of two patients, the findings are consistent with the rationale for augmentation. These case reports support the potential for an appropriately designed and powered clinical trial to examine the efficacy of glucocorticoids in augmenting the effects of psychotherapy for PTSD. Keywords: Glucocorticoids; PTSD; cortisol; treatment; prolonged exposure; learning; memory (Published: 27 December 2010) Citation: European Journal of Psychotraumatology 2010, 1: 5643 - DOI: 10.3402/ejpt.v1i0.5643 For the abstract or full text in other languages, please see Supplementary files in the column to the right (under Reading Tools).