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

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 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) ★★★★★★☆


Embedded ImageDesign:

randomised controlled trial.

Embedded ImageAllocation:


Embedded ImageBlinding:

blinded (outcome assessors).*

Embedded ImageFollow up period:

9 months.

Embedded ImageSetting:

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

Embedded ImagePatients:

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.

Embedded ImageIntervention:

after a 3 week self monitoring …

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  • * See glossary.

  • For correspondence: Dr A Ehlers, Institute of Psychiatry, London, UK.

  • Sources of funding: Wellcome Trust and Oxfordshire National Health Service Trust Research and Development Fund.

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