Schizophrenia Clinical Trial
Official title:
Narrative Exposure Therapy in Patients With Psychotic Disorders and a Posttraumatic Stress Disorder
Adverse childhood experiences in psychotic disorders are associated with increased cognitive
deficits, severe psychotic symptoms, and increased comorbidity. The number of different
stress experiences also increases the probability of trauma-associated symptoms. Furthermore,
neurobiological changes play a key role in the vulnerability of individuals with early
traumas for mental and physical illnesses, among others for diseases of the schizophrenic
spectrum disorder and the further course of the disease.
The current project pursues a detailed recording of the course of symptoms in inpatients with
psychosis to link this data with a systematic recording of childhood experiences and
traumatic experiences and biological data.
On a subsample of inpatients with psychosis and a comorbid post-traumatic stress disorder
(PTSD), the researchers want to investigate whether symptom traits of existing psychotic
disorders, biomolecular parameters and cognitive functions can be influenced by a
trauma-specific treatment (NET), that has been proven to be effective in the treatment of
PTSD.
Numerous scientific findings point to the influence of stressful childhood experiences and
traumatic experiences on the risk of mental and physical illnesses, their severity and their
course. Traumatic experiences also increase the risk of demonstrating psychotic symptoms or
even develop psychotic disorders. Furthermore, the number of different stress experiences
also increases the probability of trauma-associated symptoms (symptoms of post-traumatic
stress disorder (PTSD) and dissociative experiences).
Neurobiological changes in the immune system, the defense of stress and also central nervous
circuits and structures play a key role in the vulnerability of individuals with early
traumas for mental and physical illnesses, e.g. for diseases of the schizophrenic spectrum
disorder and the further course of the disease.
The recording of stressful and traumatic life experiences has been largely neglected in
everyday clinical practice, especially in patients with a schizophrenia spectrum disorder.
The diagnosis of PTSD is rarely given in everyday clinical practice, so that trauma-specific
treatment is often not offered.
The targeted use of a scientifically proven intervention to reduce the symptoms of PTSD (NET:
Narrative Exposure Therapy) involves a change in stress-associated biomolecular parameters
and normalizes neuronal brain activity.
The current project pursues a systematic recording of childhood experiences and traumatic
experiences possibly experienced as stressful as well as a detailed recording of the course
of symptoms in inpatients with psychosis. The researchers want to investigate whether symptom
traits of existing psychotic disorders, biomolecular parameters and cognitive functions can
be influenced by a trauma-specific treatment (NET).
The current project thus is divided into two work programs:
1. The first work program includes a weekly prospective assessment of psychotic symptoms on
a sample of n=100 inpatients and links this data with results from a cross-sectional
review of traumatic and distressing childhood experiences and biological data (cortisol
awakening, tonic cortisol concentration in hair and determination of mitochondrial
respiratory activity in mononuclear cells).
2. The second work program includes the subgroup of psychotic patients with comorbid PTSD
(n=20) and includes a randomized controlled pilot study to determine the impact of
trauma therapy (NET) on the course of symptoms. In addition to the symptoms of PTSD,
psychosis-specific parameters such as cognitive functions and biological characteristics
will be repeatedly recorded pre and post (6 months and 12 months after completing trauma
therapy).
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