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Experts Discuss PTSD Treatments  As a result of concern for this country’s returning combat veterans, much attention has been devoted to PTSD in the past several years. The Department of Defense and Department of Veterans Affairs as well as the National Institutes of Health have sponsored a variety of investigations into pharmacological and psychotherapy treatments as well as alternative treatment modalities and methods, according to Col. David Benedek, M.C., who spoke at APA’s 2012 annual meeting in Philadelphia. Benedek is a professor and deputy chair of the Department of Psychiatry and associate director of the Center for the Study of Traumatic Stress at the Uniformed Services University School of Medicine in Bethesda, Md. He was one of the leaders of a session on psychopharmacology and psychotherapy for PTSD, as well as complementary and alternative approaches for the treatment of PTSD. Benedek also outlined Department of Defense and Veterans Affairs clinical practice guidelines and compared these with APA’s Clinical Practice Guidelines regarding specific management principles for postdeployment-related distress and illness. Benedek and his co-chair, Gary Wynn, M.D., co-editors of APA’s clinical manual for the management of ptsd, summarized recent and ongoing pharmacotherapy trials for PTSD and also described promising investigations into complementary and alternative treatments—particularly acupuncture. They also shared the podium with Department of Defense and Veterans Affairs experts who addressed advances in understanding the epidemiology of PTSD to include efforts to identify and manage at-risk populations and synthesize the data from previous psychotherapy trials. Col. Charles Engel, M.C., a psychiatrist in the U.S. Army and an associate professor of psychiatry at the Uniformed Services University School of Medicine, reviewed the most recent findings on the epidemiology of PTSD. He noted large-scale efforts to study the integration of treatment into primary care settings within the military and preliminary data demonstrating the feasibility of doing this. Measurement of outcomes is important to this effort. Paula Schnurr, Ph.D., the deputy executive director of the VA National Center for PTSD and a research professor of psychiatry at Dartmouth Medical School, described psychotherapy for PTSD including prolonged exposure, cognitive-behavior therapy, stress inoculation therapy, and eye movement desensitization and reprocessing, among others, noting in particular studies demonstrating that psychotherapy appears more effective than medication for combat-related PTSD. She also described research exploring ways to make therapy more effective and deliver therapy through teletechnology—especially important as soldiers return to civilian life and scatter throughout the country in nonurban areas. |
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