Evidence map›Paper›PMID 30336702›Full record

Trial reportThe American journal of psychiatry2019

Doubly Randomized Preference Trial of Prolonged Exposure Versus Sertraline for Treatment of PTSD.

Lori A Zoellner, Peter P Roy-Byrne, Matig Mavissakalian, Norah C Feeny

Abstract readComparative StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in The American journal of psychiatry, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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  9. MassedPsychological medicine · 2023
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  18. Histamine HNature communications · 2024
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

Lori A ZoellnerFrom the Department of Psychology and the Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle; and the Department of Psychiatry and the Department of Psychology, Case Western Reserve University, Cleveland.
Peter P Roy-ByrneFrom the Department of Psychology and the Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle; and the Department of Psychiatry and the Department of Psychology, Case Western Reserve University, Cleveland.
Matig MavissakalianFrom the Department of Psychology and the Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle; and the Department of Psychiatry and the Department of Psychology, Case Western Reserve University, Cleveland.
Norah C FeenyFrom the Department of Psychology and the Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle; and the Department of Psychiatry and the Department of Psychology, Case Western Reserve University, Cleveland.

Funding

CTSA INFRASTRUCTURE FOR PEDIATRIC RESEARCHUL1RR024989 · NCRR · CASE WESTERN RESERVE UNIVERSITY · PI DAVIS, PAMELA B · 2007 to 2011
$53.7M
Effectiveness of PTSD Treatment: Prolonged Exposure Therapy vs. ZoloftR01MH066347 · NIMH · UNIVERSITY OF WASHINGTON · PI ZOELLNER, LORI A · 2004 to 2014
$4.3M
Effectiveness of PTSD Treatment: PE vs ZoloftR01MH066348 · NIMH · CASE WESTERN RESERVE UNIVERSITY · PI FEENY, NORAH C · 2004 to 2014
$4.3M
NCRR NIH HHS UL1 RR024989NIMH NIH HHS R01 MH066347NIMH NIH HHS R01 MH066348
6 · The paper itself

Abstract

objectiveThe authors examined the effect of patient treatment preference on the differential effectiveness of prolonged exposure and sertraline for the treatment of posttraumatic stress disorder (PTSD).

methodIn a doubly randomized preference trial, 200 patients with PTSD viewed standardized treatment rationales prior to randomization. Patients were first randomized to choice of treatment or no choice. Those assigned to no choice were then randomized to prolonged exposure or sertraline. Acute treatment was 10 weeks, with 24-month follow-up. Interviewer-rated PTSD symptom severity was the main outcome measure, and depression, anxiety, and functioning were assessed as additional outcomes.

resultsPatients preferred prolonged exposure over sertraline (number needed to benefit [NNTB]=4.5). Using intent-to-treat analyses (N=200), both prolonged exposure and sertraline showed large gains that were maintained over 24 months. Although no differential effect was observed on interviewer-rated PTSD severity, there was a significant benefit of prolonged exposure over sertraline on interview-rated loss of PTSD diagnosis (NNTB=7.0), responder status (NNTB=5.7), and self-reported PTSD, depression, and anxiety symptoms and functioning (effect sizes, 0.35-0.44). Patients who received their preferred treatment were more likely to be adherent, lose their PTSD diagnosis (NNTB=3.4), achieve responder status (NNTB=3.4), and have lower self-reported PTSD, depression, and anxiety symptoms (effect sizes, 0.40-0.72).

conclusionsProlonged exposure and sertraline confer significant benefits for PTSD, with some evidence of an advantage for prolonged exposure. Giving patients with PTSD their preferred treatment also confers important benefits, including enhancing adherence.

Indexed as

AdultFemaleHumansImplosive TherapyMaleSelective Serotonin Reuptake InhibitorsSertralineStress Disorders, Post-TraumaticSelective Serotonin Reuptake InhibitorsSertralineAntidepressantsBehavior TherapyPosttraumatic Stress Disorder

Identifiers

PMID30336702

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.