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Telepsychiatry can help veterans with combat-related posttraumatic stress disorder

Telepsychiatry (therapy with a psychiatrist via videoconferencing) is one way to improve access to therapy for veterans suffering from combat-related posttraumatic stress disorder (PTSD), who live in rural or underserved areas, concludes a new study. Veterans who had 14 weekly 90-minute treatment sessions by telepsychiatry or in a room with a psychiatrist had similar outcomes and satisfaction with treatment 3 months later.

Christopher Frueh, of the University of Hawaii, and colleagues randomized 38 veterans with combat-related PTSD to telepsychiatry (17) or same-room therapy (21). They interviewed the veterans before treatment and 3 months later, including measures of PTSD, overall psychiatric functioning, depression, and the quality of social relationships. All veterans received cognitive-behavioral group therapy for veterans with PTSD, which focused on social and emotional rehabilitation. In this type of therapy, the psychiatrist helps the person identify thoughts (such as traumatic flashbacks) causing distress, in order to change their emotional state or behavior.

In this study, the sessions also targeted social skills training (for example, assertion, social communication, and anger management) and activities to increase social participation. Clinical changes in both groups were minimal, but with no significant differences between the two groups. The exception was that veterans who talked to a therapist in the same room felt more comfortable talking with that therapist at post-treatment followup than those in the telepsychiatry group, and were more likely to practice behaviors suggested by the therapist. Dropout and satisfaction rates were similar for both groups.

Even though the study sample was small, its findings are consistent with those of other studies demonstrating the efficacy of telepsychiatry for depression and PTSD. The study was supported in part by the Agency for Healthcare Research and Quality (HS11642).

See "A randomized trial of telepsychiatry for post-traumatic stress disorder," by Dr. Frueh, Jeannine Monnier, Ph.D., Eunsil Yim, M.S., and others in the Journal of Telemedicine and Telecare 13, pp. 142-147, 2007.

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