BMJ  2007;334:1235-1236 (16 June), doi:10.1136/bmj.39241.426192.3A

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PTSD in Northern Ireland

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Duffy et al provide evidence for the effectiveness of cognitive therapy in post-traumatic stress disorder (PTSD) in the context of terrorism and civil conflict in Northern Ireland.1 More information would have been helpful to interpret the results.

No patients were started on medications during the trial. However, 52% in the immediate therapy group were taking antidepressants already. When were these initiated in relation to the trial? Also, were any changes to the antidepressant dose allowed during the trial? Over 70% in the immediate therapy group had comorbid major depression. The effect of antidepressant initiation just before the trial or dose changes may be partly responsible for the improvement in this group's symptoms.

The percentages for the overall effectiveness of cognitive therapy are the combined scores of the immediate treatment and waiting list control groups. This makes them uncontrolled scores. The authors are not comparing two groups of patients, one receiving . . . [Full text of this article]

Adarsh Shetty, specialist registrar in general adult psychiatry

Psychiatric Unit, Derby City Hospital, Derby DE22 3NE

dradarshshetty@yahoo.co.in


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Relevant Article

Post-traumatic stress disorder in the context of terrorism and other civil conflict in Northern Ireland: randomised controlled trial
Michael Duffy, Kate Gillespie, and David M Clark
BMJ 2007 334: 1147. [Abstract] [Full Text] [PDF]

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