Residual symptoms of PTSD following Sertraline plus enhanced medication management, Sertraline plus PE, and PE plus placebo

PSYCHIATRY RESEARCH

卷:291

Article

Tripp, Jessica C.^1,2  Norman, Sonya B.^1,2,3,4  Kim, H. Myra⁵  Venners, Margaret R.⁶  Martis, Brian^1,2  Simon, Naomi M.^7,8  Stein, Murray B.^1,2  Allard, Carolyn B.^1,9  Rauch, Sheila A. M.^10,11 

[1] VA San Diego Healthcare Syst, 3350 Villa La Jolla Dr, San Diego, CA 92161 USA

[2] Univ Calif San Diego, Sch Med, 9500 Gilman Dr, La Jolla, CA 92037 USA

[3] Natl Ctr PTSD, 215 N Main St, White River Jct, VT 05009 USA

[4] VA Ctr Excellence Stress & Mental Hlth, 3350 La Jolla Village Dr,MC116B, San Diego, CA 92161 USA

[5] Univ Michigan, Consulting Stat Comp & Analyt Res, 915 E Washington St, Ann Arbor, MI 48109 USA

[6] Natl Ctr PTSD, Disseminat & Training Div, 795 Willow Rd, Menlo Pk, CA 94025 USA

[7] Massachusetts Gen Hosp, Dept Psychiat, One Bowdoin Sq, Boston, MA 02114 USA

[8] NYU, Grossman Sch Med, Dept Psychiat, One Pk Ave,8th Floor, New York, NY 10016 USA

[9] Alliant Int Univ, 10455 Pomerado Rd, San Diego, CA USA

[10] Vet Affairs Atlanta Healthcare Syst, Mental Hlth Serv Line, 1670 Clairmont Rd, Decatur, GA 30030 USA

[11] Emory Univ, Sch Med, 12 Execut Pk,3rd Floor, Atlanta, GA 30329 USA

关键词: Posttraumatic stress disorder;    Residual symptoms;    Psychotherapy;    Psychopharmacology;    Veterans;   

DOI  :  10.1016/j.psychres.2020.113279

来源: Elsevier

【 摘 要 】

Although prolonged exposure (PE) and SSRI antidepressants are effective in treating posttraumatic stress disorder (PTSD), previous studies have shown that some symptoms tend to persist. The current study compared sertraline hydrochloride plus enhanced medication management (EMM), PE plus placebo, or PE plus sertraline hydrochloride in the likelihood of each individual PTSD symptom persisting in veterans with a PTSD diagnosis. We compared the likelihood of individual PTSD symptoms persisting in those with versus without a PTSD diagnosis at posttreatment. We found no significant differences across conditions in which symptoms were likely to persist posttreatment. Among those without a PTSD diagnosis at posttreatment, sleeping difficulties (63.0%), hypervigilance (47.3%), and nightmares (45.0%) were most likely to persist. Findings indicate no consistent differences in residual symptoms between PE and medications, and shared decision making with patients is encouraged in selecting treatments. Gold standard treatments (e.g., CBT-I) may be warranted for residual symptoms like insomnia.

【 授权许可】

Free