title: Open trial of exposure therapy for PTSD among patients with severe and persistent mental illness.
abstract: OBJECTIVE
  There are few empirical data regarding effective treatment of trauma-related symptoms among individuals with severe mental illness (SMI; e.g., bipolar disorder, schizophrenia). This under-examined clinical issue is significant because rates of trauma and PTSD are higher among individuals with SMI relative to the general population, and there are sufficient data to suggest that PTSD symptoms exacerbate the overall course and prognosis of SMI.
  
  
  METHODS
  34 veterans with SMI received prolonged exposure (PE) for PTSD using an open trial study design.
  
  
  RESULTS
  Data suggest that PE is feasible to implement, well-tolerated, and results in clinically significant decreases in PTSD severity in patients with SMI. Mean CAPS scores improved 27.2 points from baseline to immediate post [95% CI for mean change: -44.3, - 10.1; p = 0.002, paired t-test, and treatment gains were maintained at 6 months [mean change from baseline to 6-months, -16.1; 95% CI: -31.0, -1.2; p = 0.034, paired t-test].
  
  
  CONCLUSIONS
  The current data support the use of exposure-based interventions for PTSD among individuals with SMI and highlight the need for rigorous randomized efficacy trials investigating frontline PTSD interventions in this patient population.
authors.affiliation: Ralph H. Johnson Veterans Affairs Medical Center & Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 109 Bee Street, Charleston, SC, 29401, USA. Electronic address: grubaugh@musc.edu.
authors.forename: Anouk L
authors.initials: AL
authors.lastname: Grubaugh
authors.affiliation: University of Wyoming, Department of Psychology, 1000 E. University Avenue, Laramie, 82071, USA.
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Clapp
authors.affiliation: The Menninger Clinic, Houston, TX & Department of Psychology, University of Hawaii, 200 W. Kawili Street, Hilo, HI, 96720, USA.
authors.forename: B Christopher
authors.initials: BC
authors.lastname: Frueh
authors.affiliation: Ralph H. Johnson Veterans Affairs Medical Center & Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 109 Bee Street, Charleston, SC, 29401, USA.
authors.forename: Peter W
authors.initials: PW
authors.lastname: Tuerk
authors.affiliation: Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Charleston, SC, 29403, USA.
authors.forename: Rebecca G
authors.initials: RG
authors.lastname: Knapp
authors.affiliation: Ralph H. Johnson Veterans Affairs Medical Center & Division of General Internal Medicine and Geriatrics, Medical University of South Carolina, 135 Rutledge Avenue, P.O. Box 250593, Charleston, SC, 29425, USA.
authors.forename: Leonard E
authors.initials: LE
authors.lastname: Egede
mesh_terms: D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007171:Implosive Therapy / Q000379:methods*; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D014728:Veterans / Q000523:psychology*
keywords: Exposure therapy; Posttraumatic stress disorder (PTSD); Prolonged exposure; Severe mental illness (SMI); Trauma