Wednesday, April 5, 2017

Interpersonal Therapy for PTSD Effective for Patients With History of Sexual Trauma

Patients who have a history of sexual trauma may be more likely to respond to interpersonal psychotherapy for posttraumatic stress disorder (PTSD) than other common psychotherapies, according to a study published yesterday in Depression and Anxiety. The findings suggest that helping patients to build trust in the aftermath of a trauma may be particularly beneficial for patients who have been victims of sexual assault.

John C. Markowitz, M.D., a research psychiatrist at the New York State Psychiatric Institute, and colleagues compared the outcomes of 110 unmedicated patients who had chronic PTSD and a score >50 on the Clinician-Administered PTSD Scale (CAPS) and were assigned to three different types of therapy over a 14-week period: weekly interpersonal psychotherapy (IPT), prolonged exposure (PE: standard, reference treatment), or relaxation therapy (RT: active control condition). 

As was previously reported in the American Journal of Psychiatry, the authors found IPT had a higher response rate (defined as >30% CAPS reduction) than RT (63% vs. 38%), and nonsignificantly lower dropout than competing treatments (IPT=15%, PE=29%, RT=34%). Among patients with comorbid major depressive disorder (MDD)—50% overall—PE dropout trended higher than in IPT.

Thirty-nine (35%) patients in the trial reported sexual trauma, 68 (62%) reported physical trauma, and 102 (93%) interpersonal trauma. Baseline CAPS scores did not differ by the presence or absence of trauma types, the authors noted in the current report. “Although all therapies had equal efficacy among patients without sexual trauma, sexually traumatized patients [had less positive outcomes] in PE and RT than in IPT,” they wrote.

Markowitz, who is also a professor of clinical psychiatry at Columbia University College of Physicians and Surgeons, told Psychiatric News that the findings suggest an advantage of IPT over PE for patients with sexual trauma. “Together, these findings hint at differential therapeutics: when to recommend one treatment over another for a given patient,” he said.

For related information, see the Psychiatric News article “Human Trafficking Should Be on Psychiatrists’ Radar.”

(Image: iStock/Porta)


The content of Psychiatric News does not necessarily reflect the views of APA or the editors. Unless so stated, neither Psychiatric News nor APA guarantees, warrants, or endorses information or advertising in this newspaper. Clinical opinions are not peer reviewed and thus should be independently verified.