Efficacy and cost effectiveness of intensive exposure-based trauma focused treatment for PTSD: a randomized controlled trial.

Research problem and specific questionsPost-traumatic stress disorder (PTSD) is a debilitating psychiatric condition strongly linked to subsequent psychiatric and medical problems and increased risk to die by suicide.

Evidence based treatment such as prolonged exposure are seldom available in regular care.  60% of patients fail to demonstrate clinically significant symptom change. One reason for the low success rate is that a high proportion of patients drop out of treatment. Hence, there is an urgent need for treatments that can decrease dropout rates and increase availability.

A more intensive treatment approach has been suggested to achieve faster recovery rate as well as a decreased dropout rate.

Is intensive exposure-based treatment (I-PE) more efficacious than weekly delivered sessions regarding PTSD symptoms, drop out and cost-effectiveness?Data and methodThe main objectives are to investigate long-term efficacy, potential mechanisms of change and cost-effectiveness of intensive exposure-based treatment (I-PE) for PTSD in a randomized controlled trial (N=140) comparing I-PE with weekly delivered exposure-based treatment.

Outcome measures will include, but not be limited to, gold-standard clinician rated symptoms of PTSD, dropout rate, speed of recovery, and health economical aspects.Societal relevance and utilizationThe proposed project contributes to Forte’s strategic agenda and UN’s Sustainable Development Goals.

There is large gap between need of treatment and supply.

I-PE may be a more cost-effective, evidence-based treatment for PTSD that results in a faster recovery rate, decreased dropouts and increased availability of treatment.

In addition, it can potentially decrease societal and health care costs through more efficient administration of treatment, reduced waiting times, reduced therapist resources, and less sick leave.Plan for project realizationParticipants will be recruited through referrals to Traumaprogrammet, Psykiatri Sydväst, where a feasibility study (N=35) has showed the intervention and recruitment procedures to be feasible and the treatment to preliminarily be effective.

All procedures and treatment have been refined based on interviews with the participants.

Clinician and self-administered measures will be used at baseline, during treatment, post-treatment, 1-month (primary endpoint), 6-month, and 12-month follow-up by assessors blinded to treatment allocation. Funding from Forte is sought for three years.