A randomized trial of self-management and psychoeducational group therapies for comorbid chronic posttraumatic stress disorder and depressive disorder

J Trauma Stress. 2007 Jun;20(3):221-37. doi: 10.1002/jts.20214.

Abstract

The authors randomized 101 male veterans with chronic combat-related posttraumatic stress disorder (PTSD) and depressive disorder to an evidence-based depression treatment (self-management therapy; n = 51) or active-control therapy (n = 50). Main outcome measures for efficacy, using intention-to-treat analyses, were subjective and objective PTSD and depression scales at pretest, posttest, and 3-, 6-, and 12-month follow-up. Other measures included treatment compliance, satisfaction, treatment-targeted constructs, functioning, service utilization, and costs. Self-management therapy's modestly greater improvement on depression symptoms at treatment completion disappeared on follow-up. No other differences on symptoms or functioning appeared, although psychiatric outpatient utilization and overall outpatient costs were lower with self-management therapy. Despite success in other depressed populations, self-management therapy produced no clinically significant effect in depression with chronic PTSD.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Combat Disorders / diagnosis
  • Combat Disorders / economics
  • Combat Disorders / psychology
  • Combat Disorders / therapy*
  • Combined Modality Therapy
  • Comorbidity
  • Cost-Benefit Analysis
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / economics
  • Depressive Disorder, Major / psychology
  • Depressive Disorder, Major / therapy*
  • Dysthymic Disorder / diagnosis
  • Dysthymic Disorder / economics
  • Dysthymic Disorder / psychology
  • Dysthymic Disorder / therapy*
  • Female
  • Follow-Up Studies
  • Health Services / economics
  • Health Services / statistics & numerical data
  • Humans
  • Male
  • Mental Health Services / economics
  • Mental Health Services / statistics & numerical data
  • Middle Aged
  • Patient Education as Topic* / economics
  • Psychotherapy, Group* / economics
  • Psychotropic Drugs / therapeutic use
  • Self Care / economics
  • Self Care / psychology*
  • Utilization Review / statistics & numerical data
  • Veterans / psychology*

Substances

  • Psychotropic Drugs