Pragmatic Comparative Effectiveness of Primary Care Treatments for Posttraumatic Stress Disorder

Is brief trauma-focused psychotherapy more effective than selective serotonin reuptake inhibitors for the treatment of posttraumatic stress disorder in primary care?Results of this randomized clinical trial including 700 patients found that engagement in both treatments was challenging for many patients. Patients randomized to psychotherapy did not have significantly greater decreases in symptom severity than patients randomized to pharmacotherapy, with patients in both groups experiencing clinically meaningful improvement.These findings indicate that primary care patients with posttraumatic stress disorder benefit from both brief trauma-focused psychotherapy and pharmacotherapy, but additional support may be needed to better promote treatment engagement.

Corresponding Author: John C. Fortney, PhD, Department of Psychiatry and Behavioral Sciences, Division of Population Health, School of Medicine, University of Washington, 1959 NE Pacific St, Box 356560, Seattle, WA 98195-6560 (fortneyj@uw.edu).

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