Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

Articles   |    
Associations of Psychotherapy Dose and SSRI or SNRI Refills With Mental Health Outcomes Among Veterans With PTSD
Hana J. Shin, Ph.D.; Mark A. Greenbaum, M.S., M.A.; Shaili Jain, M.D.; Craig S. Rosen, Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300234
View Author and Article Information

Dr. Shin is with the Psychology Service, U.S. Department of Veterans Affairs (VA) Long Beach Healthcare System, Long Beach, California (e-mail: hana.shin@va.gov). Mr. Greenbaum is with the Mental Illness Research, Education and Clinical Center, and Dr. Jain and Dr. Rosen are with the National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, California. Dr. Jain and Dr. Rosen are also with the Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Stanford, California.

Copyright © 2014 by the American Psychiatric Association

text A A A
PDF of the full text article.

Objective  This study assessed associations between psychotherapy and pharmacotherapy for posttraumatic stress disorder (PTSD) and longitudinal changes in PTSD, depression, and mental health functioning among U.S. veterans diagnosed as having PTSD.

Methods  Information about self-reported symptoms experienced from .5 to over three years was collected from 482 veterans diagnosed as having PTSD. Administrative data from the U.S. Department of Veterans Affairs (VA) were used to calculate initiation of a course of selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs), days of medication coverage, and number of PTSD-related psychotherapy visits during the year after a baseline survey. Hierarchical linear modeling was used to analyze the effects of psychotherapy dose, initiation of an SSRI or SNRI, and medication coverage on symptoms over one year.

Results  In the year after baseline, over half of the sample (55%) received no psychotherapy for PTSD, and only 8% met the VA’s proposed standard of eight PTSD-related sessions within 14 weeks. Nearly half of the participants (47%) were prescribed an SSRI or SNRI and 37% completed a 90-day trial in the year after baseline. Participants’ symptoms improved slightly over time. Participants who received eight or more psychotherapy sessions in 14 weeks, completed a 90-day course of SSRIs or SNRIs, or had more days of medication coverage did not improve more than participants who received less treatment.

Conclusions  These dose-of-care benchmarks were not related to symptom improvement, highlighting the importance of directly assessing the impact of particular treatments on patient outcomes rather than solely relying on process measures.

Abstract Teaser
Figures in this Article

Your Session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).




CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe

Related Content
The American Psychiatric Publishing Textbook of Psychiatry, 5th Edition > Chapter 12.  >
APA Practice Guidelines > Chapter 17.  >
Manual of Clinical Psychopharmacology, 7th Edition > Chapter 2.  >
The American Psychiatric Publishing Textbook of Psychopharmacology, 4th Edition > Chapter 56.  >
The American Psychiatric Publishing Textbook of Psychiatry, 5th Edition > Chapter 12.  >
Topic Collections
Psychiatric News
APA Guidelines
PubMed Articles