title: Mental health and functional impairment outcomes following a 6-week intensive treatment programme for UK military veterans with post-traumatic stress disorder (PTSD): a naturalistic study to explore dropout and health outcomes at follow-up.
abstract: OBJECTIVE
  Combat Stress, a UK national charity for veterans with mental health problems, has been funded by the National Health Service (NHS) to provide a national specialist service to deliver treatment for post-traumatic stress disorder (PTSD). This paper reports the efficacy of a PTSD treatment programme for UK veterans at 6 months follow-up.
  
  
  METHODS
  A within subject design.
  
  
  METHODS
  UK veterans with a diagnosis of PTSD who accessed Combat Stress.
  
  
  METHODS
  246 veterans who received treatment between late 2012 and early 2014.
  
  
  METHODS
  An intensive 6-week residential treatment programme, consisting of a mixture of individual and group sessions. Participants were offered a minimum of 15 individual trauma-focused cognitive behavioural therapy sessions. In addition, participants were offered 55 group sessions focusing on psychoeducational material and emotional regulation.
  
  
  METHODS
  Clinicians completed measures of PTSD and functional impairment and participants completed measures of PTSD, depression, anger and functional impairment.
  
  
  RESULTS
  We observed significant reductions in PTSD scores following treatment on both clinician completed measures (PSS-I: -13.0, 95% CI -14.5 to -11.5) and self-reported measures (Revised Impact of Events Scale (IES-R): -16.5, 95% CI -19.0 to -14.0). Significant improvements in functional impairment were also observed (eg, Health of the Nation Outcome Scales (HONOS): -6.85, 95% CI -7.98 to -5.72). There were no differences in baseline outcomes between those who completed and those who did not complete the programme, or post-treatment outcomes between those we were able to follow-up at 6 months and those lost to follow-up.
  
  
  CONCLUSIONS
  In a naturalistic study we observed a significant reduction in PTSD scores and functional impairment following treatment. These improvements were maintained at 6 month follow-up. Our findings suggest it may be helpful to take a closer look at combining individual trauma-focused cognitive behaviour therapy and group sessions when treating veterans with PTSD. This is the first UK study of its kind, but requires further evaluation.
authors: Combat Stress, Leatherhead, UK King's Centre for Military Health Research, King's College London, London, UK.
authors: Dominic
authors: D
authors: Murphy
authors: Combat Stress, Leatherhead, UK.
authors: Georgina
authors: G
authors: Hodgman
authors: Combat Stress, Leatherhead, UK.
authors: Carron
authors: C
authors: Carson
authors: Combat Stress, Leatherhead, UK.
authors: Lucy
authors: L
authors: Spencer-Harper
authors: Combat Stress, Leatherhead, UK.
authors: Mark
authors: M
authors: Hinton
authors: King's Centre for Military Health Research, King's College London, London, UK.
authors: Simon
authors: S
authors: Wessely
authors: Combat Stress, Leatherhead, UK.
authors: Walter
authors: W
authors: Busuttil
mesh_terms: D000328:Adult; D001521:Behavior Therapy; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D010352:Patient Dropouts / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D000067073:Psychological Trauma / Q000523:psychology; D011615:Psychotherapy, Group; D012114:Residential Treatment; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome; D006113:United Kingdom; D014728:Veterans / Q000523:psychology*; D000067398:War-Related Injuries / Q000523:psychology
keywords: MENTAL HEALTH