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Predictors of Long-Term Treatment Outcome in Combat and Peacekeeping Veterans With Military-Related PTSD

J Clin Psychiatry 2014;75(11):e1299–e1305
10.4088/JCP.13m08796

Objective: Posttraumatic stress disorder (PTSD) is a significant psychiatric condition that may result from exposure to combat; it has been associated with severe psychosocial dysfunction. This study examined the predictors of long-term treatment outcomes in a group of veterans with military-related PTSD.

Method: The study consisted of a retrospective chart review of 151 consecutive veterans treated at an outpatient clinic for veterans with psychiatric disorders resulting from their military operations between January 2002 and May 2012. The diagnosis of PTSD was made using the Clinician-Administered PTSD Scale. As part of treatment as usual, all patients completed the PTSD Checklist-Military version and Beck Depression Inventory (BDI-II) at intake and at each follow-up appointment, the Short-Form Health Survey (SF-36) at intake, and either the SF-36 or the 12-item Short-Form Health Survey at follow-up. All patients received psychoeducation about PTSD and combined pharmacotherapy and psychotherapy.

Results: Analyses demonstrated a significant and progressive improvement in PTSD severity over the 2-year period ([n = 117] Yuan-Bentler χ240 = 221.25, P < .001). We found that comorbid depressive symptom severity acted as a significant predictor of PTSD symptom decline (β = −.44, SE = .15, P = .004). However, neither alcohol misuse severity nor the number of years with PTSD symptoms (chronicity) was a significant predictor of treatment response.

Conclusions: This study highlights the importance of treating comorbid symptoms of depression aggressively in veterans with military-related PTSD. It also demonstrates that significant symptom reduction, including loss of probable PTSD diagnosis, is possible in an outpatient setting for veterans with chronic military-related PTSD.