scholarly journals Using patient‐reported outcomes to understand the effectiveness of guideline‐concordant care for post‐traumatic stress disorder in clinical practice

2019 ◽  
Author(s):  
Brian Shiner ◽  
Jiang Gui ◽  
Christine Leonard Westgate ◽  
Paula P. Schnurr ◽  
Bradley V. Watts ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Patient Reported Outcomes ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Patient Reported ◽  
Post Traumatic

scholarly journals Patient-reported outcomes in post-traumatic stress disorder. Part I: focus on psychological treatment

2014 ◽  
Vol 16 (2) ◽  
pp. 213-226 ◽  
Keyword(s):  
Clinical Research ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Patient Reported Outcomes ◽  
Rating Scales ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Patient Reports ◽  
Patient Reported ◽  
Post Traumatic

Since 2000, patient reports have contributed significantly to the widening diagnostic criteria for post-traumatic stress disorder, notably with the inclusion of complex, repeated, and indirect threat to people who develop symptoms. This paper describes and explains why patient reports matter, through worldwide mental health users' movements and the human rights movement. It looks at 46 recent patient-reported outcomes of preferred psychological treatments in clinical research and practice, and compares them with clinician-reported outcomes, using rating scales that diagnose and measure therapeutic gains. Attention is given to one qualitative study of survivors of the London bombings as an example of patients' personal traumatic experiences. Understanding patients' views and their limitations can help increase success in trauma-focused therapy outcomes, particularly where patients fail to engage with or complete treatment, where they doubt the validity of the treatment, or do not see it as culturally appropriate, or fear of revisiting the past. Specific recommendations are made for a more collaborative approach with patients in psychiatric and community care and clinical research.

scholarly journals Problems with the post-traumatic stress disorder diagnosis and its future in DSM-V

2008 ◽  
Vol 192 (1) ◽  
pp. 3-4 ◽  
Author(s):  
Gerald M. Rosen ◽  
Robert L. Spitzer ◽  
Paul R. McHugh
Keyword(s):  
Clinical Practice ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Dsm V ◽  
Post Traumatic ◽  
Diverse Cultures

SummarySignificant issues challenge the diagnosis of post-traumatic stress disorder (PTSD). Yet, applications of the PTSD ‘model’ have been extended to an increasing array of events and human reactions across diverse cultures. These issues have implications for clinical practice and for those who revise criteria in the DSM-V.

Evolution of post-traumatic stress disorder and patient reported-outcomes during the COVID-19 pandemic among cancer patients of the French longitudinal COVIPACT study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 12123-12123
Author(s):  
Florence Joly ◽  
Sophie Lefèvre-Arbogast ◽  
Olivier Rigal ◽  
Etienne Bastien ◽  
Lydia Guittet ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Patient Reported Outcomes ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Patient Reported ◽  
Post Traumatic

12123 Background: Sudden COVID-19 pandemic has enforced social restrictions across the globe, including social distancing, curfews and total lockdowns, which persist in many parts of the world. Beyond these measures, cancer patients have faced up to the threat of the risk of severe COVID-19 infections and the adaptations of medical oncology practices, with potential impact on their psychological well-being. We aimed to follow Post-Traumatic Stress Disorder (PTSD) symptoms and other Patient-Reported Outcomes (PROs) over this period among cancer patients from the French COVIPACT study. Methods: The COVIPACT study (NCT04366154) included patients with solid/hematologic malignancy receiving medical treatment during the first lockdown in outpatient departments of two cancer centers. Patients were asked to fulfill validated questionnaires on PTSD symptoms (IES-R), insomnia (ISI), quality of life (FACT-G) and cognition (FACT-Cog) at baseline (M0, first lockdown, Apr/May 2020), 3 months (M3, post-lockdown, Jul/Aug 2020) and 6 months (M6, second lockdown, Oct/Nov 2020). PTSD was defined as an IES-R score ≥33 and moderate/severe insomnia as an ISI score ≥15. Higher values on the FACT-G (range 0-108) and FACT-Cog (PCI subscale range 0-72) indicated better quality of life and cognition, respectively. Changes in PROs over time were assessed using mixed models for repeated measures. Results: Among the 734 patients included in COVIPACT, 579, 347 and 328 completed the questionnaires at M0, M3 and M6, respectively: median age, 64 years, 72% women, 59% metastatic status. Patients were mostly treated for breast (44%), lung, head and neck (20%), digestive (16%) and gynecologic cancers (11%). We observed a J-shaped evolution of PTSD over time, affecting 21.2% of patients during the first lockdown, 13.6% the post-lockdown and 23.6% during the second lockdown (p for time < 0.001). Moreover, patients reported linear deterioration of cognitive function over follow-up (p < 0.001). No change was observed in any dimension of quality of life (p for time = 0.06). 24.3%, 27.1% and 28.1% of the patients reported insomnia at M0,M3 and M6 (p for time = 0.35). At each time, PTSD was associated with more insomnia, worst quality of life and cognitive complain. At all the times, ≥50% of patients with PTSD reported insomnia compared to ≤23% in non-PTSD patients (p < 0.001). In addition, there was a clinically significant difference of ≥16 points on the FACT-G and ≥8 points on the FACT-Cog PCI between PTSD and non-PTSD patients (p < 0.001) at the all times. Conclusions: More than 20% of patients have developed PTSD during the different periods of lockdown, with strong association with poor quality of life, cognitive complain and insomnia. Psychosocial support promoting emotional resilience should be largely offered to cancer patients to prevent and/or reduce PTSD. Clinical trial information: NCT04366154.

scholarly journals Implementing Narrative Exposure Therapy for unaccompanied asylum-seeking minors with post-traumatic stress disorder: A pilot feasibility report

2019 ◽  
Vol 25 (1) ◽  
pp. 213-226 ◽  
Author(s):  
Glorianne Said ◽  
Dorothy King
Keyword(s):  
Clinical Practice ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Functional Outcomes ◽  
Stress Disorder ◽  
Exposure Therapy ◽  
Routine Clinical Practice ◽  
Post Traumatic Stress ◽  
Narrative Exposure Therapy ◽  
Post Traumatic

There are high rates of post-traumatic stress disorder (PTSD) in unaccompanied asylum-seeking minors (UAM) and there is a requirement for feasible, acceptable and evidence-based treatments. Narrative Exposure Therapy (NET) is a short-term treatment for PTSD following multiple traumatic events. This article aims to examine the applicability of NET for UAM in routine clinical practice and to provide preliminary feasibility, acceptability and effectiveness data. The participants were four UAM receiving NET within a dedicated child and adolescent mental health service for refugee children. Semi-structured interviews were conducted to understand the acceptability of this approach and standardised measures of PTSD were used to provide preliminary data regarding the effectiveness of NET for these clients. The clients attended NET consistently with few missed appointments. At post-treatment, two clients’ symptom scores were below the clinical cut-off for PTSD and all three clients who completed NET met reliable improvement criteria. The clients reported improvements in functional outcomes and mentioned that they would encourage other young people with similar difficulties to engage in NET. This study was limited by the small sample size and naturalistic time limitations in clinicians’ contracts. This article highlights that it is possible to implement NET within routine clinical practice and observed improvements in PTSD symptoms and functional outcomes for UAM.

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