What Happens Next? Maintenance of Gains After Discharge From VA Residential PTSD Treatment.

IF 1.6 4区医学 Q3 CLINICAL NEUROLOGY Journal of Nervous and Mental Disease Pub Date : 2024-04-01 Epub Date: 2024-01-06 DOI:10.1097/NMD.0000000000001749

Peter P Grau, Ilan Harpaz-Rotem, Mark A Ilgen, Dara Ganoczy, Rebecca K Sripada

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Abstract

Abstract: Residential posttraumatic stress disorder (PTSD) treatment in the Department of Veterans Affairs is helpful for many Veterans, yet the majority experience symptom rebound after discharge. This study examined a national cohort of Veterans (n = 1872) who completed VA residential PTSD treatment and identified factors associated with maintenance of gains from discharge to 4-month follow-up. We generated three logistic regression models based on response profiles during residential treatment. In the "marginal responders" group, 1-3 "booster" sessions of PTSD treatment were associated with decreased odds of maintenance of gains (odds ratio [OR], 0.42), whereas in the "clinically significant responders" group, these sessions were associated with increased odds of maintenance of gains (OR, 2.89). Greater pain severity was associated with decreased odds of maintenance of gains in the "clinically significant responder" group (OR, 0.90). Results demonstrate several avenues for intervention including targeting pain severity and matching aftercare psychotherapy to Veteran residential treatment response.

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接下来会发生什么？从退伍军人事务部创伤后应激障碍住院治疗出院后收益的维持。

摘要：退伍军人事务部的创伤后应激障碍（PTSD）住院治疗对许多退伍军人很有帮助，但大多数人在出院后症状会出现反弹。本研究调查了全国完成退伍军人事务部创伤后应激障碍住院治疗的退伍军人队列（n = 1872），并确定了从出院到 4 个月随访期间维持治疗效果的相关因素。我们根据住院治疗期间的反应情况建立了三个逻辑回归模型。在 "边缘反应者 "组中，1-3 次创伤后应激障碍治疗 "强化 "疗程与收益维持几率下降相关（几率比 [OR], 0.42），而在 "临床显著反应者 "组中，这些疗程与收益维持几率增加相关（OR, 2.89）。在 "临床显著应答者 "组中，疼痛严重程度越高，维持疗效的几率越低（OR，0.90）。研究结果表明了几种干预途径，包括针对疼痛严重程度和根据退伍军人住院治疗反应匹配术后心理治疗。

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来源期刊

Journal of Nervous and Mental Disease 医学-精神病学

CiteScore

2.90

自引率

5.30%

发文量

233

审稿时长

3-8 weeks

期刊介绍： The Journal of Nervous and Mental Disease publishes peer-reviewed articles containing new data or ways of reorganizing established knowledge relevant to understanding and modifying human behavior, especially that defined as impaired or diseased, and the context, applications and effects of that knowledge. Our policy is summarized by the slogan, "Behavioral science for clinical practice." We consider articles that include at least one behavioral variable, clear definition of study populations, and replicable research designs. Authors should use the active voice and first person whenever possible.