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Comorbid posttraumatic stress disorder and major depressive disorder: The usefulness of a sequential treatment approach within a randomised design.

Abstract：

:Cognitive Processing Therapy (CPT) and Behavioural Activation Therapy (BA) were used to treat individuals with comorbid posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). Fifty-two individuals (48 women, 4 men) were randomized to CPT alone (n = 18), CPT then BA for MDD (n = 17), or BA then CPT (n = 17). Presenting trauma was primarily interpersonal (87 %). Participants were assessed at pre-, posttreatment, and 6-month follow-up. PTSD and MDD symptoms were the main outcome of interest; trauma cognitions, rumination, and emotional numbing were secondary outcomes. All groups showed sizeable reductions in PTSD and depression (effect sizes at follow-up ranging between 1.02-2.54). A pattern of findings indicated CPT/BA showed better outcomes in terms of larger effect sizes and loss of diagnoses relative to CPT alone and BA/CPT. At follow-up greater numbers of the CPT/BA group were estimated to have achieved good end-state for remission of both PTSD and depression (49 %, CI95 [.26, .73]) relative to CPT alone (18 %, CI95 [.03, .38]) and BA/CPT (11 %, CI95 [.01, .29]). Although tempered by the modest sample size, the findings suggest that individuals with comorbid PTSD and MDD may benefit from having PTSD targeted first before remaining MDD symptoms are addressed.

journal_name

J Anxiety Disord

journal_title

Journal of anxiety disorders

authors

Angelakis S,Weber N,Nixon RDV

doi

10.1016/j.janxdis.2020.102324

subject

Has Abstract

pub_date

2020-12-01 00:00:00

pages

102324

eissn

0887-6185

issn

1873-7897

pii

S0887-6185(20)30138-9

journal_volume

76

pub_type

杂志文章

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