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Comparison of the effectiveness of trauma-focused cognitive behavioral therapy and paroxetine treatment in PTSD patients: design of a randomized controlled trial.

Polak AR, Witteveen AB, Visser RS, Opmeer BC, Vulink N, Figee M, Denys D, Olff M - BMC Psychiatry (2012)

Bottom Line: This study is unique for its direct comparison of the most commonly used psychological intervention (TF-CBT) and pharmacological intervention (paroxetine) on (cost-) effectiveness on the short and the long term.The anticipated results will provide relevant evidence concerning long-term effects and relapse rates and will be beneficial in reducing societal costs.It may also provide information on who may benefit most from which type of intervention.

View Article: PubMed Central - HTML - PubMed

Affiliation: Academic Medical Center, Department of Anxiety Disorders, University of Amsterdam, Meibergdreef 5, Amsterdam 1105 AZ, The Netherlands. a.r.polak@amc.nl

ABSTRACT

Background: The two most common interventions for Posttraumatic Stress Disorder (PTSD) are pharmacological treatment with SSRIs such as paroxetine and psychological treatment such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). International guidelines recommend trauma-focused psychological interventions for all PTSD patients as first-line treatment (NICE). However, no clear-cut evidence is available to support this recommendation.

Methods/design: In order to compare pharmacological treatment (paroxetine) and psychological treatment (TF-CBT) in (cost-) effectiveness on the short and the long term, we will randomize 90 patients with chronic PTSD to either paroxetine (24 weeks) or TF-CBT (10-12 weeks). We will assess symptom severity and costs before and after the intervention with the Clinician Administered PTSD Scale (CAPS), the Clinical Global Impression Scale (CGI) and the Trimbos/iMTA questionnaire for Costs associated with Psychiatric Illness (TiC-P).

Discussion: This study is unique for its direct comparison of the most commonly used psychological intervention (TF-CBT) and pharmacological intervention (paroxetine) on (cost-) effectiveness on the short and the long term. The anticipated results will provide relevant evidence concerning long-term effects and relapse rates and will be beneficial in reducing societal costs. It may also provide information on who may benefit most from which type of intervention. Some methodological issues will be discussed.

Trial registration: Dutch Trial registration: NTR2235.

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Related in: MedlinePlus

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Mentions: The study is designed as a randomized controlled trial comparing TF-CBT and paroxetine treatment. The randomization and allocation procedure will be performed by a researcher who has no further role in data collection. The study design was set up with one pre-treatment assessment and four post-treatment assessments (at 1 week, 6 months, 12 months and 18 months) but before starting data-collection the authors added an assessment at 3 months as well (see Figure 1). All assessments will be performed by research workers blinded for the allocated treatment. The study will be performed at the department of psychiatry of the Academic Medical Center (AMC) in Amsterdam. Patients will be recruited over the course of 3 years, starting November 2009.


Comparison of the effectiveness of trauma-focused cognitive behavioral therapy and paroxetine treatment in PTSD patients: design of a randomized controlled trial.

Polak AR, Witteveen AB, Visser RS, Opmeer BC, Vulink N, Figee M, Denys D, Olff M - BMC Psychiatry (2012)

Flowchart.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3539952&req=5

Figure 1: Flowchart.
Mentions: The study is designed as a randomized controlled trial comparing TF-CBT and paroxetine treatment. The randomization and allocation procedure will be performed by a researcher who has no further role in data collection. The study design was set up with one pre-treatment assessment and four post-treatment assessments (at 1 week, 6 months, 12 months and 18 months) but before starting data-collection the authors added an assessment at 3 months as well (see Figure 1). All assessments will be performed by research workers blinded for the allocated treatment. The study will be performed at the department of psychiatry of the Academic Medical Center (AMC) in Amsterdam. Patients will be recruited over the course of 3 years, starting November 2009.

Bottom Line: This study is unique for its direct comparison of the most commonly used psychological intervention (TF-CBT) and pharmacological intervention (paroxetine) on (cost-) effectiveness on the short and the long term.The anticipated results will provide relevant evidence concerning long-term effects and relapse rates and will be beneficial in reducing societal costs.It may also provide information on who may benefit most from which type of intervention.

View Article: PubMed Central - HTML - PubMed

Affiliation: Academic Medical Center, Department of Anxiety Disorders, University of Amsterdam, Meibergdreef 5, Amsterdam 1105 AZ, The Netherlands. a.r.polak@amc.nl

ABSTRACT

Background: The two most common interventions for Posttraumatic Stress Disorder (PTSD) are pharmacological treatment with SSRIs such as paroxetine and psychological treatment such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). International guidelines recommend trauma-focused psychological interventions for all PTSD patients as first-line treatment (NICE). However, no clear-cut evidence is available to support this recommendation.

Methods/design: In order to compare pharmacological treatment (paroxetine) and psychological treatment (TF-CBT) in (cost-) effectiveness on the short and the long term, we will randomize 90 patients with chronic PTSD to either paroxetine (24 weeks) or TF-CBT (10-12 weeks). We will assess symptom severity and costs before and after the intervention with the Clinician Administered PTSD Scale (CAPS), the Clinical Global Impression Scale (CGI) and the Trimbos/iMTA questionnaire for Costs associated with Psychiatric Illness (TiC-P).

Discussion: This study is unique for its direct comparison of the most commonly used psychological intervention (TF-CBT) and pharmacological intervention (paroxetine) on (cost-) effectiveness on the short and the long term. The anticipated results will provide relevant evidence concerning long-term effects and relapse rates and will be beneficial in reducing societal costs. It may also provide information on who may benefit most from which type of intervention. Some methodological issues will be discussed.

Trial registration: Dutch Trial registration: NTR2235.

Show MeSH
Related in: MedlinePlus