Treatment for PTSD
The study found that the correlation between PTSD symptom improvement and reduced diabetes risk was independent of the number of psychotherapy sessions a veteran attended, “suggesting that a healthy adherer effect, or a general orientation to improve health, is unlikely to explain our observations,” the researchers said.
The clinics where the veterans in the study received care were likely to offer the therapies for PTSD that are known to work well. “In this study, we weren’t able to look at specific treatments for PTSD, but we know that certain treatments are most effective for treating PTSD,” Norman said. “The clinics we pulled data from for this study have high rates of offering those treatments.”
The VA and DoD clinical practice guidelines for management of PTSD recommended individual trauma-focused psychotherapy over pharmacotherapy, based on two meta-analyses that found trauma-focused psychotherapies produced greater improvement and that the improvements lasted longer.
Recommended therapies include prolonged exposure therapy, cognitive processing therapy, and eye movement desensitization and reprocessing therapy as well as specific cognitive behavioral therapies for PTSD, brief eclectic psychotherapy, narrative exposure therapy and written narrative exposure. The therapies can be done in weekly sessions and are associated with significant reduction in symptoms or even remission, Norman noted.
“Effective therapies for PTSD have been available for well over a decade now, but some veterans don’t know they are available and think they will have to deal with PTSD forever,” Norman said. “I hope the study helps clinicians understand that there are effective treatments now and refer veterans to those programs.”
While the veterans in the study got better, either through treatment or spontaneously, “the most effective way to get better is to get effective treatment for PTSD,” she added. “Clinicians should be assessing veterans’ risk for PTSD and their risk for diabetes and encouraging anyone with PTSD to get treatment.”
Based on the results of this study, Norman pointed out that choosing to start therapy “could help with PTSD and health problems that don’t even have yet.”
- Scherrer JF, Salas J, Norman SB, Schnurr PP, Chard KM, Tuerk P, Schneider FD, van den Berk-Clark C, Cohen BE, Friedman MJ, Lustman PJ. Association Between Clinically Meaningful Posttraumatic Stress Disorder Improvement and Risk of Type 2 Diabetes. JAMA Psychiatry. 2019 Aug 21. doi: 10.1001/jamapsychiatry.2019.2096. [Epub ahead of print]
