title: Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE): A Pilot Study in Alcohol-dependent Women.
abstract: Posttraumatic stress disorder (PTSD) and substance use disorders are highly comorbid. Effective treatments are largely lacking. This pilot study evaluated the safety and feasibility of a novel intervention, Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE), in preparation for a randomized controlled trial.
  
  
  
  Twenty-two treatment-seeking women with current DSM-IV-TR PTSD and alcohol dependence (AD) were recruited. Participants received COPE. Safety and feasibility were evaluated, as were efficacy-related outcomes: PTSD and depression symptom severity, alcohol use, craving, and dependence severity.
  
  
  
  No adverse events occurred. COPE was implemented in routine clinical practice. Among the assessed women, 95.8% were eligible to participate. Treatment attendance and completion were higher than in previous studies. Post treatment, all efficacy-related outcomes, including PTSD and depression symptom severity, alcohol use, craving, and dependence severity, were significantly reduced.
  
  
  
  COPE was safe and feasible to use. Concerns that trauma-focused, exposure-based therapy might promote relapse in this population appear unwarranted. Our findings provide initial evidence suggestive of COPE efficacy for comorbid PTSD and AD in women. These results provide a strong rationale for investigating the efficacy of COPE for comorbid PTSD and AD in women in a randomized controlled trial.
authors.affiliation: Department of Clinical Neuroscience (AP, AM), Karolinska Institutet; EWA Outpatient Unit (AP, AM), The Stockholm Centre for Dependency Disorders, Stockholm, Sweden; Department of Psychiatry (SEB, TKK, KTB), Medical University of South Carolina; Ralph H. Johnson Veterans Affairs (VA) Medical Center (SEB, KTB), Charleston, SC; Laboratory of Clinical and Experimental Studies (MLS), NIAAA, Bethesda, MD; Department of Clinical and Experimental Medicine (MH), Linköping University, Linköping, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Persson
authors.forename: Sudie E
authors.initials: SE
authors.lastname: Back
authors.forename: Therese K
authors.initials: TK
authors.lastname: Killeen
authors.forename: Kathleen T
authors.initials: KT
authors.lastname: Brady
authors.forename: Melanie L
authors.initials: ML
authors.lastname: Schwandt
authors.forename: Markus
authors.initials: M
authors.lastname: Heilig
authors.forename: Åsa
authors.initials: Å
authors.lastname: Magnusson
mesh_terms: D000328:Adult; D015897:Comorbidity; D005260:Female; D006801:Humans; D007171:Implosive Therapy / Q000379:methods*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000628:therapy*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000628:therapy*