Value of Most Post-Traumatic Stress Treatments 'Uncertain'

VA-sponsored study could influence care of returning U.S. veterans

By E.J. Mundell
HealthDay Reporter

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THURSDAY, Oct. 18 (HealthDay News) -- Doctors have little quality evidence to rely on when deciding how best to treat post-traumatic stress disorder (PTSD) in returning U.S. veterans, a new government-sponsored review of the data concludes.

The Institute of Medicine study was requested by the U.S. Department of Veterans Affairs, which noted that about 12.6 percent of personnel fighting in Iraq, and 6.2 percent of those returning from Afghanistan, have experienced symptoms of PTSD.

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Unfortunately, an overabundance of studies with inadequate or flawed designs make it impossible to say whether drug treatments or most psychotherapies can help fight PTSD, the authors of the report told reporters at a press conference Thursday.

Only exposure therapy -- where the patient is re-exposed to the original stressor in a safe, controlled environment -- shows some solid data bolstering its claim to effectiveness, the researchers said.

As for other therapies, "I think it is important to point out that our assessment of inadequate evidence does not mean that the treatments are ineffective," said Dr. Alfred Berg, chairman of the committee that wrote the report and professor of family medicine at the University of Washington School of Medicine. "In most cases, we just don't know because of the absence of good data," he said.

The report is not meant as a guide for patients and their physicians as they work to fight PTSD, which can involve chronic and frightening nightmares, flashbacks, as well as avoidance behaviors that all diminish quality of life.

Instead, the report is meant to assess the current state of the science when it comes to PTSD research, said Dr. David Matchar, director of the Center for Clinical Health Policy Research at Duke University Medical Center.

"We don't want to see people getting a message that they should avoid seeking care because care doesn't work -- that's not at all the message of this report," said report co-author Matchar, who is also a professor of medicine at Duke. "It would be a mistake to receive this as a guideline -- it is not a guideline."

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