12-month follow-up of intensive outpatient treatment for PTSD combining prolonged exposure therapy, EMDR and physical activity.

BACKGROUND: Preliminary evidence shows promising treatment outcomes at short-term follow-up for intensive posttraumatic stress disorder (PTSD) treatment, but long-term follow-up studies are sparse. This study is a sequel to a previous pilot study and open trial, set out to investigate treatment outcomes at 12-month follow-up for outpatients completing an 8-day intensive treatment for PTSD. METHODS: All patients were diagnosed with PTSD and had multiple previous psychotherapy attempts (M = 3.1). Patients were assessed at pre-treatment, post-treatment, 3- and 12-month follow-up. Of 35 treated patients, 32 (91.4%) attended the long-term follow-up assessment. The treatment programme combined prolonged exposure therapy, eye movement desensitization and reprocessing, and physical activity. RESULTS: The effect sizes indicated large reductions in symptoms of PTSD, depression, anxiety, interpersonal problems, and well-being. Changes in functioning showed a small-medium effect. Results were stable across the follow-up period. The treatment response rates showed that 46-60% of patients achieved recovery with respect to PTSD symptoms, and that 44-48% no longer met diagnostic criteria for PTSD. CONCLUSIONS: Time-limited and concentrated outpatient treatment for PTSD can yield large and enduring positive outcomes. Controlled trials are needed to establish relative efficacy. TRIAL REGISTRATION: The study was registered in Current Research Information System In Norway (Cristin). Cristin-project-ID: 654,790. Date of registration: 18.03.2019.

Intensive outpatient treatment for PTSD: an open trial combining prolonged exposure therapy, EMDR, and physical activity.

Background: Intensive outpatient treatment could be a promising option for patients with post-traumatic stress disorder (PTSD). Objective: The aim of the study was to test the effectiveness of an eight-day (two-week) intensive treatment for PTSD within a public health care setting (open trial design). Method: Eighty-nine patients were offered the choice between intensive treatment and spaced individual treatment, of which 34 (38.2%) chose the intensive format. Patients were assessed with self-report batteries and interviews at pre-treatment, start of treatment, post-treatment and three-month follow-up. Each day consisted of individual Prolonged Exposure therapy, Eye Movement Desensitization and Reprocessing therapy, group psychoeducation, and physical activity. Therapists rotated between patients. Results: Between 55 and 62% of the patients showed a clinically significant change (recovery) in symptoms of PTSD, and the effect sizes were large (d = 1.38-1.52). Patients also showed reduction in symptoms of depression and anxiety, along with improved well-being and interpersonal functioning. Changes in social and work functioning were more ambiguous. There were no dropouts, attendance was high, and patients were highly satisfied with the treatment. Conclusions: The intensive programme was an attractive and effective treatment option for patients with PTSD.

Antecedentes: El tratamiento ambulatorio intensivo podría ser una opción prometedora para los pacientes con trastorno de estrés postraumático (TEPT).Objetivo: El objetivo del estudio fue probar la efectividad de un tratamiento intensivo de 8 días (2 semanas) para el TEPT dentro de un entorno de atención de salud pública (diseño de ensayo abierto).Método: Se ofreció a 89 pacientes elegir entre tratamiento intensivo y tratamiento individual espaciado, de los cuales 34 (38,2%) eligieron el formato intensivo. Los pacientes fueron evaluados con baterías de autoinforme y entrevistas antes del tratamiento, al inicio del tratamiento, después del tratamiento y a los 3 meses de seguimiento. Cada día consistió en terapia de exposición prolongada individual, terapia de reprocesamiento y desensibilización por movimientos oculares, psicoeducación grupal y actividad física. Los terapeutas rotaron entre los pacientes.Resultados: Entre el 55-62% de los pacientes mostraron un cambio clínicamente significativo (recuperación) en los síntomas del TEPT, y los tamaños del efecto fueron grandes (d = 1,38­1,52). Los pacientes también mostraron una reducción en los síntomas de depresión y ansiedad, junto con mejoría en bienestar y funcionamiento interpersonal. Los cambios en el funcionamiento social y laboral fueron más ambiguos. No hubo abandonos, la asistencia fue alta y los pacientes estaban altamente satisfechos con el tratamiento.Conclusiones: El programa intensivo fue una opción de tratamiento atractiva y efectiva para pacientes con TEPT.