Predictors of Long-Term Treatment Outcome in Combat and Peacekeeping Veterans With Military-Related PTSD

被引:35
作者
Richardson, J. Don [1 ,2 ,3 ]
Contractor, Ateka A. [6 ]
Armour, Cherie [8 ]
St Cyr, Kate [1 ]
Elhai, Jon D. [6 ,7 ]
Sareen, Jitender [4 ,5 ]
机构
[1] Parkwood Hosp, St Josephs Hlth Care London, Operat Stress Injury Clin, London, England
[2] McMaster Univ, Dept Psychiat & Behav Neurosci, Hamilton, ON, Canada
[3] Univ Western Ontario, Dept Psychiat, London, ON N6A 3K7, Canada
[4] Deer Lodge, Operat Stress Injury Clin, Winnipeg, MB, Canada
[5] Univ Manitoba, Dept Psychiat, Winnipeg, MB R3T 2N2, Canada
[6] Univ Toledo, Dept Psychol, Toledo, OH 43606 USA
[7] Univ Toledo, Dept Psychiat, Toledo, OH 43606 USA
[8] Univ Ulster, Dept Psychol, Coleraine, Londonderry, North Ireland
关键词
POSTTRAUMATIC-STRESS-DISORDER; QUALITY-OF-LIFE; EYE-MOVEMENT DESENSITIZATION; MENTAL-HEALTH PROBLEMS; PROLONGED EXPOSURE; PSYCHOMETRIC PROPERTIES; ADJUNCTIVE THERAPY; CARE UTILIZATION; DOUBLE-BLIND; DEPRESSION;
D O I
10.4088/JCP.13m08796
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
Objective: Posttraumatic stress disorder (PTSD) is a significant psychiatric condition that may result from exposure to combat; it has been associated with severe psychosocial dysfunction. This study examined the predictors of long-term treatment outcomes in a group of veterans with military-related PTSD. Method: The study consisted of a retrospective chart review of 151 consecutive veterans treated at an outpatient clinic for veterans with psychiatric disorders resulting from their military operations between January 2002 and May 2012. The diagnosis of PTSD was made using the Clinician-Administered PTSD Scale. As part of treatment as usual, all patients completed the PTSD Checklist-Military version and Beck Depression Inventory (BDI-II) at intake and at each follow-up appointment, the Short-Form Health Survey (SF-36) at intake, and either the SF-36 or the 12-item Short-Form Health Survey at follow-up. All patients received psychoeducation about PTSD and combined pharmacotherapy and psychotherapy. Results: Analyses demonstrated a significant and progressive improvement in PTSD severity over the 2-year period ([n = 117] Yuan-Bentler chi(2)(40) = 221.25, P < .001). We found that comorbid depressive symptom severity acted as a significant predictor of PTSD symptom decline (beta = -.44, SE = .15, P = .004). However, neither alcohol misuse severity nor the number of years with PTSD symptoms (chronicity) was a significant predictor of treatment response. Conclusions: This study highlights the importance of treating comorbid symptoms of depression aggressively in veterans with military-related PTSD. It also demonstrates that significant symptom reduction, including loss of probable PTSD diagnosis, is possible in an outpatient setting for veterans with chronic military-related PTSD. (C) Copyright 2014 Physicians Postgraduate Press, Inc.
引用
收藏
页码:E1299 / E1305
页数:7
相关论文
共 100 条
[71]  
RICHARDSON JD, 2010, MOOD ANXIETY DISORDE, V1, P1
[72]   Augmentation of sertraline with prolonged exposure in the treatment of posttraumatic stress disorder [J].
Rothbaum, Barbara O. ;
Cahill, Shawn P. ;
Foa, Edna B. ;
Davidson, Jonathan R. T. ;
Compton, Jill ;
Connor, Kathryn M. ;
Astin, Millie C. ;
Hahn, Chang-Gyu .
JOURNAL OF TRAUMATIC STRESS, 2006, 19 (05) :625-638
[73]   Current concepts in pharmacotherapy for posttraumatic stress disorder [J].
Schoenfeld, FB ;
Marmar, CR ;
Neylan, HC .
PSYCHIATRIC SERVICES, 2004, 55 (05) :519-531
[74]   Bringing the war back home - Mental health disorders among 103 788 US veterans returning from Iraq and Afghanistan seen at Department of Veterans Affairs facilities [J].
Seal, Karen H. ;
Bertenthal, Daniel ;
Miner, Christian R. ;
Sen, Saunak ;
Marmar, Charles .
ARCHIVES OF INTERNAL MEDICINE, 2007, 167 (05) :476-482
[75]   Treatment of posttraumatic stress disorder: A review [J].
Shalev, AY ;
Bonne, O ;
Eth, S .
PSYCHOSOMATIC MEDICINE, 1996, 58 (02) :165-182
[76]  
Shalev AY, 2000, J CLIN PSYCHIAT, V61, P33
[77]   Quality of life in social anxiety disorder compared with panic disorder and the general population [J].
Simon, NM ;
Otto, MW ;
Korbly, NB ;
Peters, PM ;
Nicolaou, DC ;
Pollack, MH .
PSYCHIATRIC SERVICES, 2002, 53 (06) :714-718
[78]  
Snijders T., 2002, MULTILEVEL ANAL INTR
[79]  
SOUTHWICK SM, 1991, AM J PSYCHIAT, V148, P179
[80]  
Statistics Canada, 2002, CAN COMM HLTH SURV C