A pilot randomized controlled trial of combined trauma-focused CBT and sertraline for childhood PTSD symptoms.
OBJECTIVE
To examine the potential benefits of adding a selective serotonin reuptake inhibitor, sertraline, versus placebo, to trauma-focused cognitive-behavioral therapy (TF-CBT) for improving posttraumatic stress disorder and related psychological symptoms in children who have experienced sexual abuse.


METHODS
Twenty-four 10- to 17-year-old female children and adolescents and their primary caretakers were randomly assigned to receive TF-CBT + sertraline or TF-CBT + placebo for 12 weeks.


RESULTS
Both groups experienced significant improvement in posttraumatic stress disorder and other clinical outcomes from pre- to posttreatment with no significant group x time differences between groups except in Child Global Assessment Scale ratings, which favored the TF-CBT + sertraline group.


CONCLUSIONS
Only minimal evidence suggests a benefit to adding sertraline to TF-CBT. A drawback of adding sertraline was determining whether TF-CBT or sertraline caused clinical improvement for children with comorbid depression. Current evidence therefore supports an initial trial of TF-CBT or other evidence-supported psychotherapy for most children with PTSD symptoms before adding medication.
Cohen
Judith A
JA
Drexel University College of Medicine, Allegheny General Hospital, Department of Psychiatry, Pittsburgh, USA. jcohen1@wpahs.org
Mannarino
Anthony P
AP
Perel
James M
JM
Staron
Virginia
V
D000293:Adolescent; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D020280:Sertraline / Q000627:therapeutic use*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology* / Q000628:therapy*; D016896:Treatment Outcome
D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline