title: Long-term responses to treatment in UK veterans with military-related PTSD: an observational study.
abstract: Military-related trauma can be difficult to treat. Evaluating longer term responses to treatment and identifying which individuals may need additional support could inform clinical practice. We assessed 1-year outcomes in UK veterans treated for post-traumatic stress disorder (PTSD).
  
  
  
  Within-participant design.
  
  
  
  The intervention was offered by Combat Stress, a mental health charity for veterans in the UK.
  
  
  
  The sample included 401 veterans who completed a standardised 6-week residential treatment. Of these, 268 (67%) were successfully followed up a year after the end of treatment.
  
  
  
  A range of health outcomes were collected pretreatment and repeated at standard intervals post-treatment. The primary outcome was severity of PTSD symptoms, and secondary outcomes included measures of other mental health difficulties (depression, anxiety and anger), problems with alcohol, and social and occupational functioning.
  
  
  
  Significant reductions in PTSD severity were observed a year after treatment (PSS-I: -11.9, 95% CI -13.1 to -10.7). Reductions in the secondary outcomes were also reported. Higher levels of post-treatment functional impairment (0.24, 95% CI 0.08 to 0.41) and alcohol problems (0.18, 95% CI 0.03 to 0.32) were associated with poorer PTSD treatment response at 12 months.
  
  
  
  This uncontrolled study suggests the longer term benefits of a structured programme to treat UK veterans with PTSD. Our findings point to the importance of continued support targeted for particular individuals post-treatment to improve longer term outcomes.
authors.affiliation: Combat Stress, Leatherhead, UK King's Centre for Military Health Research, King's College London, London, UK.
authors.forename: Dominic
authors.initials: D
authors.lastname: Murphy
authors.affiliation: Combat Stress, Leatherhead, UK.
authors.forename: Lucy
authors.initials: L
authors.lastname: Spencer-Harper
authors.affiliation: Combat Stress, Leatherhead, UK.
authors.forename: Carron
authors.initials: C
authors.lastname: Carson
authors.affiliation: Combat Stress, Leatherhead, UK.
authors.forename: Emily
authors.initials: E
authors.lastname: Palmer
authors.affiliation: Combat Stress, Leatherhead, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Hill
authors.affiliation: Combat Stress, Leatherhead, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Sorfleet
authors.affiliation: King's Centre for Military Health Research, King's College London, London, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Wessely
authors.affiliation: Combat Stress, Leatherhead, UK.
authors.forename: Walter
authors.initials: W
authors.lastname: Busuttil
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000534:rehabilitation*; D003130:Combat Disorders / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation; D003863:Depression / Q000453:epidemiology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011615:Psychotherapy, Group; D012114:Residential Treatment; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000534:rehabilitation* / Q000628:therapy; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology; D014728:Veterans / Q000523:psychology
keywords: MENTAL HEALTH; Military; PTSD; Trauma; Veterans