Post-traumatic stress disorder in the context of terrorism and other civil conflict in Northern Ireland: randomised controlled trial.
OBJECTIVE
To evaluate the effectiveness of cognitive therapy for post-traumatic stress disorder related to terrorism and other civil conflict in Northern Ireland.


METHODS
Randomised controlled trial.


METHODS
Community treatment centre, Northern Ireland.


METHODS
58 consecutive patients with chronic post-traumatic stress disorder (median 5.2 years, range 3 months to 32 years) mostly resulting from multiple traumas linked to terrorism and other civil conflict.


METHODS
Immediate cognitive therapy compared with a waiting list control condition for 12 weeks followed by treatment. Treatment comprised a mean of 5.9 sessions during 12 weeks and 2.0 sessions thereafter.


METHODS
Primary outcome measures were patients' scores for post-traumatic stress disorder (post-traumatic stress diagnostic scale) and depression (Beck depression inventory). The secondary outcome measure was scores for occupational and social functioning (work related disability, social disability, and family related disability) on the Sheehan disability scale.


RESULTS
At 12 weeks after randomisation, immediate cognitive therapy was associated with significantly greater improvement than the waiting list control group in the symptoms of post-traumatic stress disorder (mean difference 9.6, 95% confidence interval 3.6 to 15.6), depression (mean difference 10.1, 4.8 to 15.3), and self reported occupational and social functioning (mean difference 1.3, 0.3 to 2.5). Effect sizes from before to after treatment were large: post-traumatic stress disorder 1.25, depression 1.05, and occupational and social functioning 1.17. No change was observed in the control group.


CONCLUSIONS
Cognitive therapy is an effective treatment for post-traumatic stress disorder related to terrorism and other civil conflict.


BACKGROUND
Current Controlled Trials ISRCTN16228473 [controlled-trials.com].
Duffy
Michael
M
University of Ulster at Magee, Londonderry, Northern Ireland BT48 7JL. m.duffy1@ulster.ac.uk
Gillespie
Kate
K
Clark
David M
DM
D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003220:Conflict, Psychological; D004651:Employment / Q000706:statistics & numerical data; D006801:Humans; D007398:Interpersonal Relations; D009660:Northern Ireland / Q000453:epidemiology; D019989:Persons with Intellectual Disabilities / Q000706:statistics & numerical data; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D023481:Terrorism / Q000523:psychology*; D016896:Treatment Outcome