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
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Comparative Study
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Randomized Controlled Trial
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Research Support, U.S. Gov't, Non-P.H.S.
MeSH terms
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Combat Disorders / diagnosis
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Combat Disorders / economics
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Combat Disorders / psychology
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Combat Disorders / therapy*
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Combined Modality Therapy
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Comorbidity
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Cost-Benefit Analysis
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Depressive Disorder, Major / diagnosis
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Depressive Disorder, Major / economics
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Depressive Disorder, Major / psychology
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Depressive Disorder, Major / therapy*
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Dysthymic Disorder / diagnosis
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Dysthymic Disorder / economics
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Dysthymic Disorder / psychology
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Dysthymic Disorder / therapy*
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Female
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Follow-Up Studies
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Health Services / economics
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Health Services / statistics & numerical data
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Humans
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Male
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Mental Health Services / economics
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Mental Health Services / statistics & numerical data
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Middle Aged
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Patient Education as Topic* / economics
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Psychotherapy, Group* / economics
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Psychotropic Drugs / therapeutic use
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Self Care / economics
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Self Care / psychology*
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Utilization Review / statistics & numerical data
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Veterans / psychology*