Post-operative PTSD intervention improves physical outcomes in trauma patients

Feb 14th  – Year-long multidisciplinary PTSD treatment reduced psychological symptoms and functional limitations six months after surgery.

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1. Year-long multidisciplinary PTSD treatment reduced psychological symptoms and functional limitations six months after surgery.

2. Study included patients typically excluded in PTSD trials with comorbidities such as traumatic brain injury, active substance abuse/dependence, and history of multiple traumas.

PTSD treatment resulted in decreased psychological symptoms and improved physical function at six and twelve months after the initial injury and surgical admission. As this study had notably frequent follow-up with thorough assessments, authors were able to assess significant improvement in a multitude of outcome measures including functional outcome, PTSD symptoms and patient satisfaction. This study’s intensive post-operative mental health treatment may be difficult to replicate in resource-poor settings that characterize large urban trauma centers. However, the results indicate that lower-intensity interventions such as early treatment of PTSD-associated insomnia and routine comprehensive case management can have significant impact on this population. More rigorous interventions such as cognitive-behavioral therapy and SSRI titration can be used for a subset of trauma survivors.

Click to read the study in Annals of Surgery

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1. Year-long multidisciplinary PTSD treatment reduced psychological symptoms and functional limitations six months after surgery

2. Study included patients typically excluded in PTSD trials with comorbidities such as traumatic brain injury, active substance abuse/dependence, and history of multiple traumas

This [randomized control] study: enrolled 207 surgical trauma inpatients exhibiting PTSD symptoms to receive either a stepped care intervention or regular treatment. Patients were screened for PTSD with validated surveys and their symptoms frequently re-assessed throughout the year. The intensity of the intervention, including care management, psychoactive medication, and CBT, was increased when indicated by worsening symptoms. If substance abuse or dependence was an issue, trained care workers provided targeted motivational interviewing therapy. Patients receiving stepped post-traumatic care exhibited less PTSD symptoms and had improved physical function as assessed by a validated questionnaire. Additionally, patients in the intervention arm were more satisfied with their healthcare and mental health services.

In sum: PTSD treatment resulted in decreased psychological symptoms and improved physical function at six and twelve months after the initial injury and surgical admission. As this study had notably frequent follow-up with thorough assessments, authors were able to assess significant improvement in a multitude of outcome measures including functional outcome, PTSD symptoms and patient satisfaction. This study’s intensive post-operative mental health treatment may be difficult to replicate in resource-poor settings that characterize large urban trauma centers. However, the results indicate that lower-intensity interventions such as early treatment of PTSD-associated insomnia and routine comprehensive case management can have significant impact on this population. More rigorous interventions such as cognitive-behavioral therapy and SSRI titration can be used for a subset of trauma survivors.

Click to read the study in Annals of Surgery

By Asya Ofshteyn and Allen Ho

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