title: A randomized trial of self-management and psychoeducational group therapies for comorbid chronic posttraumatic stress disorder and depressive disorder.
abstract: The authors randomized 101 male veterans with chronic combat-related posttraumatic stress disorder (PTSD) and depressive disorder to an evidence-based depression treatment (self-management therapy; n = 51) or active-control therapy (n = 50). Main outcome measures for efficacy, using intention-to-treat analyses, were subjective and objective PTSD and depression scales at pretest, posttest, and 3-, 6-, and 12-month follow-up. Other measures included treatment compliance, satisfaction, treatment-targeted constructs, functioning, service utilization, and costs. Self-management therapy's modestly greater improvement on depression symptoms at treatment completion disappeared on follow-up. No other differences on symptoms or functioning appeared, although psychiatric outpatient utilization and overall outpatient costs were lower with self-management therapy. Despite success in other depressed populations, self-management therapy produced no clinically significant effect in depression with chronic PTSD.
authors.affiliation: Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA. ndunn@bcm.tmc.edu
authors.forename: Nancy Jo
authors.initials: NJ
authors.lastname: Dunn
authors.forename: Lynn P
authors.initials: LP
authors.lastname: Rehm
authors.forename: Jeanne
authors.initials: J
authors.lastname: Schillaci
authors.forename: Julianne
authors.initials: J
authors.lastname: Souchek
authors.forename: Paras
authors.initials: P
authors.lastname: Mehta
authors.forename: Carol M
authors.initials: CM
authors.lastname: Ashton
authors.forename: Elisia
authors.initials: E
authors.lastname: Yanasak
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Hamilton
mesh_terms: D003130:Combat Disorders / Q000175:diagnosis / Q000191:economics / Q000523:psychology / Q000628:therapy*; D003131:Combined Modality Therapy; D015897:Comorbidity; D003362:Cost-Benefit Analysis; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000191:economics / Q000523:psychology / Q000628:therapy*; D019263:Dysthymic Disorder / Q000175:diagnosis / Q000191:economics / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000191:economics / Q000706:statistics & numerical data; D008875:Middle Aged; D010353:Patient Education as Topic / Q000191:economics; D011615:Psychotherapy, Group / Q000191:economics; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012648:Self Care / Q000191:economics / Q000523:psychology*; D014600:Utilization Review / Q000706:statistics & numerical data; D014728:Veterans / Q000523:psychology*
chemical_list: D011619:Psychotropic Drugs