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Introduction: After an acute infection with the corona virus 10-20% of those affected suffer from ongoing or new symptoms. A causal therapy for the phenomenon known as Long/Post-COVID is still lacking and specific therapies addressing psychosocial needs of these patients are imperatively needed. The aim of the PsyLoCo-study is developing and piloting a psychotherapeutic manual, which addresses Long/Post-COVID-related psychosocial needs and supports in coping with persistent bodily symptoms as well as depressive or anxiety symptoms. Methods and analysis: This pilot trial implements a multi-centre, 2-arm (N=120; allocation ratio: 1:1), parallel group, randomised controlled design. The pilot trial is designed to test the feasibility and estimate the effect of 1) a 12-session psychotherapeutic intervention compared to 2) a wait-list control condition on psychosocial needs as well as bodily and affective symptoms in patients suffering from Long/Post-COVID. The intervention uses an integrative, manualized, psychotherapeutic approach. The primary study outcome is health-related quality of life. Outcome variables will be assessed at three timepoints, pre-intervention (t1), post-intervention (t2) and three months after completed intervention (t3). To determine the primary outcome, changes from t1 to t2 are examined. The analysis will be used for the planning of the RCT to test the efficacy of the developed intervention. Discussion: The pilot study will evaluate a 12-session treatment manual for Long/Post-COVID sufferers and the therapy components it contains. The analysis will provide insights into the extent to which psychotherapeutic treatment approaches improve the symptoms of Long/Post-COVID sufferers. The treatment manual is designed to be carried out by psychotherapists as well as people with basic training in psychotherapeutic techniques. This approach was chosen to enable a larger number of practitioners to provide therapeutic support for Long/Post-COVID patients. After completion of the pilot study, it is planned to follow up with a randomized controlled study and to develop a treatment guideline for general practitioners and interested specialists. Trial registration: The pilot trial has been registered with the German Clinical Trials Register (Deutsches Register Klinischer Studien; Trial-ID: DRKS00030866; URL: https://drks.de/search/de/trial/DRKS00030866) on March 7, 2023.
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BACKGROUND: The diagnostic criteria for Posttraumatic Stress Disorder (PTSD) differ between the DSM-5 and the ICD-11, affecting prevalence and associated metrics of PTSD. OBJECTIVE: Investigating the effects of the diverging DSM-5 and ICD-11 PTSD conceptualizations on prevalence and comorbidity rates, as well as predictor impact in a sample of foster children and adolescents using manual-specific measures. METHOD: The sample consisted of n = 145 foster children and adolescents. PTSD rates were assessed and compared utilizing the International Trauma Questionnaire - Child and Adolescent Version (ICD-11) and the Child and Adolescent Trauma Screen (DSM-5). PTSD comorbidities with Generalized Anxiety Disorder (GAD) and Major Depressive Disorder (MDD) were assessed. The predictive value of age, gender and cumulative trauma for PTSD was determined. RESULTS: A non-significant trend for higher DSM-5 (21.4%) vs. ICD-11 (16.7%) PTSD prevalence was observed. Significantly elevated DSM-5 vs. ICD-11 diagnostic rates were recorded in the re-experience (diff. = 18.3%) and hyperarousal (diff. = 10.1%) clusters. DSM-5 PTSD showed a non-significant trend for higher comorbidities with GAD and MDD. Gender and cumulative trauma predicted PTSD significantly and approximately equally according to both taxonomies. CONCLUSION: The study supports the assumption that utilizing manual-specific PTSD measures in children and adolescents leads to higher rates of DSM-5 PTSD compared to ICD-11 PTSD. The exact methodological reasons for diverging diagnostic rates need to be analysed.
Antecedentes: Los criterios de diagnóstico para el trastorno de estrés postraumático (TEPT) difieren entre el DSM-5 y el CIE-11, lo cual afecta la prevalencia y las métricas asociadas al TEPT.Objetivo: Investigar los efectos de las conceptualizaciones divergentes del TEPT entre el DSM-5 y el CIE-11, utilizando medidas específicas del manual, en las tasas de prevalencia y comorbilidad, así como el impacto predictor en una muestra de niños y adolescentes en condición de acogida familiar temporal.Método: La muestra consistió en un n = 145 niños y adolescentes en condición de acogida familiar temporal. Las tasas de TEPT se evaluaron y compararon utilizando el Cuestionario Internacional de Trauma - Versión para Niños y Adolescentes (CIE-11) y la Prueba de Detección del Trauma para Niños y Adolescentes (DSM-5). Se evaluaron las comorbilidades del TEPT, trastorno de ansiedad generalizada (TAG) y trastorno depresivo mayor (TDM). Se determinó el valor predictivo para TEPT de las variables edad, género y trauma acumulativo.Resultados: Se observó una tendencia, no-significativa, de una mayor prevalencia de TEPT para el DSM-5 (21.4%) comparado con el CIE-11 (16.7%). Se registraron tasas de diagnóstico significativamente elevadas en los grupos de re-experimentación (dif. = 18.3%) e hiperactivación (dif. = 10.1%) para el DSM-5 versus el CIE-11. El TEPT en el DSM-5 mostró una tendencia mayor, no-significativa, para las comorbilidades TAG y TDM. El género y el trauma acumulativo predijeron el TEPT de manera significativa, y aproximadamente equivalente en ambas taxonomías.Conclusión: El estudio apoya el supuesto de que la utilización de medidas TEPT específicas para el manual en niños y adolescentes conlleva tasas más altas de TEPT para el DSM-5 en comparación con el CIE-11. Es necesario analizar las razones metodológicas precisas para estas tasas de diagnóstico divergentes.