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Cognitive therapy prevented onset of chronic post-traumatic stress disorder after a motor vehicle accident

Q In patients who developed post-traumatic stress disorder (PTSD) 3 months after a motor vehicle accident, is cognitive therapy (CT) or a self help booklet (SHB) more effective than repeated assessments (RA) for preventing chronic PTSD?

Clinical impact ratings Mental health Psychiatry (specialist)

Key Words: cognitive therapy • stress disorders (post-traumatic)

The first 150 words of the full text of this article appear below.

METHODS
Design: randomised controlled trial.

Allocation: concealed.^*

Blinding: blinded (outcome assessors).^*

Follow up period: 9 months.

Setting: local accident and emergency departments of 2 hospitals in the UK.

Patients: 85 survivors of motor vehicle accidents who were 18–65 years of age, met DSM-IV criteria for PTSD in the initial months after the accident, had Posttraumatic Diagnostic Scale (PDS) scores 20, and were to receive treatment 6 months after the accident. Exclusion criteria included having no memory of the accident, history of psychosis, and need for an interpreter.

Intervention: after a 3 week self monitoring phase, patients who did not recover were stratified by sex and severity of PTSD symptoms and allocated to CT (n = 28), SHB based on cognitive behavioural therapy (n = 28), or RA (n = 29). CT comprised 12 weekly sessions during 3 months and 3 monthly booster sessions. The treatment goals were to modify excessively negative . . . [Full text of this article]

Jonathan I Bisson, BM, MRCPsych

Cardiff and Vale NHS Trust
Cardiff, UK