New research suggests care for post-traumatic stress disorder (PTSD) is complicated, even in the best cases. While experts explain that the majority of people with post-traumatic stress disorder (PTSD) recover after early treatment, a new study finds that many still suffer for years after a traumatic event — even with early clinical interventions.
In the study, investigators examined several groups of non-military individuals suffering from PTSD after a single traumatic event. The review was performed over a 12-week period and 232 individuals were followed. Research findings appear online in The Journal of Clinical Psychiatry.
All participants received either prolonged exposure therapy; cognitive therapy; treatment with selective serotonin reuptake inhibitors (SSRIs); or a placebo pill one month after the traumatic event. Researchers also followed individuals who declined treatment. All were reassessed at five months and at 36 months.
While the groups receiving prolonged exposure and cognitive therapy showed a significant reduction of symptoms by five months (61 percent better than the other groups), and their symptoms remained low for three years, the other groups, including those who declined treatment, reached the same level of low symptoms by three years.
In that sense, early-prolonged exposure and cognitive therapy significantly shortened the time to recovery, but did not reduce the after effects of PTSD as measured at the three-year.
“We assume that people living in an otherwise stable environment would have better conditions for long-term recovery than individuals who experience lengthy wars or live in a constant state of violence,” says Arieh Y. Shalev, M.D., a co-director of New York University Langone’s Steven and Alexandra Cohen Veterans Center.
“This might explain part of their spontaneous recovery without initial treatment. However, what this study tells us at its core is that there is a significant public health challenge ahead. Individuals continually expressing initial PTSD symptoms, and who are resistant to early treatment, should be the focus of future research,” Dr. Shalev adds.
“They are the ones who remain chronically distressed and disabled, and require care long after their traumatic incident. We need to find ways to identify these subjects, increase the early favorable responses to existing treatment, and find new ways to reduce the long-term burden of PTSD.”
Care for individuals with PTSD is an ongoing research agenda for Dr. Shaley and colleagues as they have developed a computational tool that can identify individuals at high-risk for PTSD. In a study published last year in BMC Psychiatry, those at high-risk for PTSD could be identified in less than two weeks after they are first seen in an emergency room following a traumatic event.
Identification and care management of PTSD is a pressing concern as approximately eight million Americans (civilian and military populations) will experience PTSD in a given year, according to the U.S. Department of Veterans Affairs’ National Center for PTSD.
Trauma is also very common in women; five out of ten women will experience a traumatic event at some point during their lifetime.