Conditions: Posttraumatic Stress Disorder (PTSD)
Keywords: PTSD Cognitive behavioral therapy (CBT) Medication augmentation Treatment-resistant PTSD Cambodian refugees Culturally sensitive treatment
Allocation: RANDOMIZED | Intervention model: PARALLEL
Enrollment: 114
Healthy volunteers: no

Brief summary:
This project aims to investigate the efficacy of two models to treat Posttraumatic Stress Disorder (PTSD) for Cambodian refugees in primary care. The first step in both models is giving a medication, which is a serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitor (SSRI/SSRN), with paroxetine being the first-line agent. For those patients who still have PTSD, the second step is either another medication or a culturally sensitive cognitive behavioral therapy (CBT). The investigators hypothesize that patients will improve in both models, but more so in the the CBT model.

Detailed description:
This project aims to investigate the efficacy of two models to treat PTSD for Cambodian refugees in primary care. The first step in both models is giving a medication (an SSRI/SSRN, e.g., paroxetine). For those who still have PTSD, the second step is either adding another medication (e.g., prazosin) or providing culturally sensitive cognitive behavioral therapy (CBT). We hypothesize that patients will improve in both models, but more so in the the CBT model. The primary outcome measure is PTSD severity as assessed by the PTSD Checklist (PCL). Eligibility requirements include having PTSD and having been old enough to remember the Khmer Rouge period.

Arms:
arm 1: In one arm, the patients will be given a medication augmentation for SSRI/SSRN-resistant PTSD arm 2: In this arm, patients will receive CBT to treat SSRI/SSRN-resistant PTSD.

Interventions: intervention 1: Medication augmentation intervention 2: CBT
Intervention descriptions: intervention 1: None intervention 2: None

Protocol document: