Prolonged Exposure, Cognitive Therapy Prevent Chronic PTSD

Prolonged exposure, cognitive therapy, delayed PE, but not escitalopram, placebo prevent chronic PTSD

THURSDAY, Oct. 6 (HealthDay News) -- Prolonged exposure (PE), delayed PE, and cognitive therapy (CT) reduce the prevalence of chronic post-traumatic stress disorder (PTSD) in survivors of traumatic events, according to a study published online Oct. 3 in the Archives of General Psychiatry.

Arieh Y. Shalev, M.D., from the Hadassah University Hospital in Jerusalem, and colleagues compared early and delayed exposure-based, cognitive, and pharmacological interventions for preventing PTSD. Traumatic event survivors were interviewed telephonically an average of 9.61 days after the trauma, and treated an average of 21.8 days after the trauma. A total of 63 participants with PTSD received 12 weekly sessions of PE, 40 received CT, 46 received two tablets of either escitalopram or placebo, and 93 were on a waiting list. After 12 weeks, and an average of 151.8 days after trauma, waiting-list participants with PTSD received PE (delayed PE). The Clinician-Administered PTSD Scale was used to determine the proportion of patients with PTSD five and nine months after the traumatic event.

The investigators found that, at five months, 21.6 and 57.1 percent of the participants in the PE group and the comparable delayed PE group, respectively, had PTSD, while 20.0 and 58.7 percent of participants in the CT group and the delayed PE group, respectively, had PTSD. The PTSD outcome did not differ between the PE and CT groups. The escitalopram and placebo subgroups showed no difference in PTSD prevalence rates. At nine months, PTSD was seen in 20.8 and 21.4 percent of participants in the PE and delayed PE group, respectively. Those who had partial PTSD prior to treatment did similarly well with and without treatment.

"Prolonged exposure, CT, and delayed PE effectively prevent chronic PTSD in recent survivors," the authors write.

One of the study authors disclosed financial ties to Lundbeck Pharmaceuticals.

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