Pacientes vítimas de abuso sexual com Transtorno de Estresse Pós-Traumático: aplicabilidade do tratamento com psicoterapia interpessoal

• Autor(a) principal: Proenca, Cecilia Roberti [UNIFESP]
• Data de Publicação: 2019
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=7780813; https://repositorio.unifesp.br/handle/11600/59575
• topic: Interpersonal Psychotherapy; Sexual Assault; Posttraumatic Stress Disorder; Adherence; Attrition.; Abuso Sexual; Transtorno De Estresse Pós-Traumático; Psicoterapia Interpessoal; Aplicabilidade; Adesão

Sexual violence has important consequences in social life and mental health of individuals who suffer this kind of trauma. Almost half of raped victims develop posttraumatic stress disorder (PTSD) following the trauma, a condition that leads to emotional dysregulation and disruption in social life and interpersonal relationships. Usually individuals mistrust their environment, isolating themselves and detaching from close people when they most need support. Majority guidelines consider psychotherapy as first line PTSD treatment, specially prolonged exposure (PE), however, many patients cannot tolerate being exposed to trauma memories. Objective: Assess the applicability of interpersonal psychotherapy (IPT) for treating women with a confirmed diagnosis of PTSD between one and six months after being raped. Method: Thirty-two women diagnosed with PTSD after sexual trauma were included in the trial to be treated with IPT during 14 weeks. Their PTSD, depressive and anxiety symptoms were clinically evaluated using specific scales before and after the treatment. Results: Out of thirty-two women who fulfilled inclusion criteria, one was excluded after 7th week of treatment because of suicidal ideation. Four did not even started psychotherapy treatment and five dropped out after beginning IPT (dropout rate was 29%, considering the exclusion women). There was no statistically significant difference between sertraline and IPT arm adherence in the clinical trial (dropout rates were 29% and 34,5% respectively, p=0,45). The clinical evaluation of twenty-two women who concluded IPT arm showed a significantly improvement in depressive (p<0.001), anxiety (p=0.001) and PTSD (p<0.001) symptoms. Discussion: Differently from the initial hypothesis, adherence to IPT treatment in this research was similar to literature data about dropout rates among patients who undergo exposure treatments. This result suggests that difficulties to adhere our protocol could be related to socioeconomic conditions of our sample, once other studies found dropout rates of IPT-PTDS around 15%. Conclusion: Considering IPT-PTSD was not inferior to PE in terms of adherence, and women presented a significant improvement in clinical PDTS, anxiety and depressive symptoms, IPT seems to be an interesting alternative psychotherapeutic approach for PTSD due to sexual trauma.