Research conducted at the Hadassah University Medical Center and recently published in the Archives of General Psychiatry, demonstrates that Cognitive Behavioral Therapy (CBT) is more effective than drug therapy in preventing the development of Post Traumatic Stress Disorder (PTSD). However, the study concludes that a significant number of people who suffer from PTSD will heal without ever being treated, that for many, clinical intervention often does not help and that delayed treatment will not increase the risk of chronic symptoms. The study was conducted by Prof. Arieh Shalev, former Head of Hadassah’s Department of Psychiatry, to evaluate the most effective method of preventing PTSD. In his analysis of the data Prof. Shalev concludes that "Unfortunately, we were unable prove that anti-depressant drug therapy succeeds in early prevention of developing ongoing PTSD.”

 

The study involved 242 participants who had suffered a traumatic event shortly before treatment that developed into full-blown PTSD. They were divided into four groups: two were treated using Cognitive Behavioral Therapy – one group with exposure therapy that involved a controlled breathing exercise to recreate the traumatic experience and the other involved the subject's view of the world the trauma had created. Half of the third group were treated with anti-depressants [Cipralex/ Lexapro], and the other half, the control group with placebos. Members of the fourth group, who exhibited PTSD symptoms even after five months, were also treated with exposure therapy.

 

Eight months after the trial began 77–79 percent of the group treated with Cognitive Behavioral Therapy recovered fully, whereas only 53–58 percent in the medicated group recovered. In addition, results showed that the drug therapy was no more effective than no treatment at all. Researchers further tested to determine whether immediate therapy for people who don't suffer full blown PTSD is required. "These important findings show us that not everyone needs treatment in order to recover, only those who have full-blown diagnosable PTSD,” explains Prof. Shalev. "This way we can devote our treatment resources to those who will not recover without treatment, by a using full clinical diagnosis before treatment even begins", says Prof. Shalev. As for cases of delayed clinical intervention, Prof. Shalev clarifies that a delay is certainly acceptable if there are no early clinical treatment options.

 

Additional researchers included Dr. Sara Freedman, Head of the Department of Psychiatry’s Cognitive Behavioral Therapy (CDT) Center; Dr. Rhonda Adessky, therapist in the CBT Center; Dr Yael L.E. Ankri of the Department of Psychiatry; and Yossi Israeli-Shalev, who coordinated and headed this complex trial.

 

PTSD is common among approximately seven percent of the general population; in disaster areas the rates are even higher. PTSD symptoms are extremely invasive.

 

They include nightmares and flashbacks, being overly alert and emotionally numb, accompanied by avoidance of stimulation. More often than not, people who suffer from PTSD also suffer from depression.

 

source: Hadassah University Medical Center