A recent issue of the Journal of Anxiety Disorders (Vol. 21, 2007) focused on the troubling possibility that the PTSD (posttraumatic stress disorder) construct is not nearly as valid as has been assumed. The articles are both fascinating and provocative and are well worth reading.
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At least in Britain, it’s official: psychotherapy works better than medication for PTSD. You shouldn’t be too surprised. The last time we covered PTSD (TCPR April 2004) we reviewed the SSRIs and found them to have evidence of only modest efficacy.
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Dr. Osser, as an attending psychiatrist at a VA unit in which you evaluate many patients with PTSD, how do you typically approach establishing a valid and reliable diagnosis of PTSD in your patients?
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The results of the cognitive therapy component of the NIMH-funded STAR-D trial were finally released. Recall that in STAR-D, about 4,000 depressed patients were initially enrolled and were all given Celexa (citalopram) at an average dose of about 40 mg/day (see TCPR January 2007 for a rundown of STAR-D findings).
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Fibromyalgia is usually considered a rheumatologic condition characterized by at least 3 months of widespread pain and the presence of tender points. About two thirds of fibromyalgia patients also suffer from depression, and many such patients eventually find their way to our offices.
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Project Match was a large, government-funded research project conducted in the 1990s that showed equivalent benefit of AA, cognitive behavioral therapy, and motivational enhancement therapy in alcoholism. Researchers recently reported on an effort to test brief versions of the Project Match therapies for alcohol abusing patients.
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Dr. Aiken is the Editor in Chief of The Carlat Psychiatry Report; director of the Mood Treatment Center in North Carolina, where he maintains a private practice combining medication and therapy along with evidence-based complementary and alternative treatments; and Assistant Professor NYU Langone Department of Psychiatry. He has worked as a research assistant at the NIMH and a sub-investigator on clinical trials, and conducts research on a shoestring budget out of his private practice. Follow him on Twitter and find him on LinkedIn.
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