Effect of standardized post-coercion review session on symptoms of PTSD: results from a randomized controlled trial
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ORIGINAL PAPER
Effect of standardized post‑coercion review session on symptoms of PTSD: results from a randomized controlled trial Alexandre Wullschleger1,2 · Angelika Vandamme1 · Juliane Mielau1 · Lara Renner3 · Felix Bermpohl1 · Andreas Heinz1 · Christiane Montag1 · Lieselotte Mahler1 Received: 27 May 2020 / Accepted: 7 November 2020 © The Author(s) 2020
Abstract Objective Post-coercion review is increasingly regarded as a mean to reduce the negative consequences of coercive interventions, including the development of posttraumatic symptoms. However, the efficacy of this intervention in preventing posttraumatic symptoms or PTSD has not been sufficiently studied. The objective of this study is to examine the influence of a single, standardized post-coercion review session on the development or exacerbation of PTSD symptoms in patients with psychotic disorders. Methods In a multi-center, two-armed, randomized controlled trial, patients who experienced coercive interventions during current hospitalization were either randomized to standard treatment or an intervention group receiving a guideline-based, standardized reflecting review session. Factorial MANCOVA and subsequent ANCOVAs investigated the effects of the post-coercion reflecting review session on post-traumatic symptoms as measured by the subscales of the Impact of Events Scale-Revised (IES-R). Similarly, the effect of the intervention on the intensity of the peritraumatic reactions measured by the Peritraumatic Distress Inventory (PDI) was analyzed by conducting a factorial ANCOVA. Results N = 82 patients were included in an intention-to-treat analysis. MANCOVA and post hoc ANCOVAs revealed a significant main effect of the intervention for the IES-R subscales intrusion and hyperarousal, when controlling for levels of peritraumatic distress, whereby intervention group participants presented lower respective mean scores. There was no significant difference regarding the intensity of the peritraumatic reaction. Conclusion Standardized post-coercion review contributes to a reduction of the burden of PTSD symptoms in patients with psychotic disorders experiencing coercive interventions in acute settings and shall be recommended as a measure of trauma-informed care. The trial was registered at ClinicalTrials.gov (ID NCT03512925) on 01/30/2018 (retrospectively registered). Keywords Post coercion review · Coercion · PTSD · Trauma · Psychosis
Christiane Montag and Lieselotte Mahler contributed equally to this work. * Alexandre Wullschleger [email protected] 1
Department of Psychiatry and Psychotherapy, Berlin Institute of Health, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, HumboldtUniversität Zu Berlin, Campus Charité Mitte, Berlin, Germany
2
Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, 2, Chemin du Petit‑Bel‑Air, 1226 Thonex, Switzerland
3
Steinbeis Transfer Institute Medical Psychology, Steinbeis-Hochschule Berlin, Berlin, Germany
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