Cognitive analytic therapy for the treatment of post-traumatic stress disorder: a randomized controlled trial

BackgroundPost-traumatic stress disorder represents a multifaceted clinical entity with a profound impact on mental health. This study was conducted to evaluate the effects of cognitive analytic therapy on the manifestations of post-traumatic stress disorder. Materials and methodsFrom May 21, 2023, to July 7, 2023, we conducted a randomized control trial in the outpatient clinic of a psychiatry Hospital. Participants were Iran-Iraq war veterans (N = 40) with a confirmed diagnosis of post-traumatic stress disorder. They were randomly allocated to cognitive analytic therapy and control groups. The primary outcome was re-experiencing, and the secondary outcomes included avoidance, hyperarousal, depression, anxiety, and numbness scores measured by appropriate questionnaires before and after the interventions. The cognitive analytic therapy group received a weekly program totaling 12 sessions of therapy adjunct to pharmacotherapy, each session lasting 90 min, and the control group received only pharmacotherapy. ResultsWithin-group analysis showed that cognitive analytic therapy (N = 19) decreased all symptom scores (all p < 0.001), while the control group (N = 20) showed a decrease in hyper-arousal, depression, and anxiety (p < 0.001) scores. Between-group analysis implied that cognitive analytic therapy was more successful than usual pharmacotherapy in decreasing all outcome scores (all p < 0.001) ConclusionA 12-session program of cognitive analytic therapy was effective in alleviating re-experiencing, avoidance, hyper-arousal, depression, anxiety, and numbness in post-traumatic stress disorder. It was safe and acceptable by participants reflected by a high retention rate. We recommend the incorporation of cognitive analytic therapy to the treatment of post-traumatic stress disorder. HIGHLIGHTS A 12-session of CAT is effective for treating PTSD. The interventions control re-experiencing, avoidance, and hyper-arousal in PTSD. Also, they decrease depression, anxiety, and numbness in patients with PTSD. Overall, CAT is safe and acceptable to participants. Participants' retention is high for CAT with a minimum dropout.