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Journal ArticleDOI

PTSD Treatment for Soldiers After Combat Deployment: Low Utilization of Mental Health Care and Reasons for Dropout

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TLDR
Treatment reach for PTSD after deployment remains low to moderate, with a high percentage of soldiers not accessing care or not receiving adequate treatment.
Abstract
Are efforts to engage veterans in PTSD treatment falling short? A study from the Walter Reed Army Institute of Research found a sharp drop-off in treatment seeking after a mental health evaluation. Seventy-five percent of veterans who were referred for further evaluation after a postdeployment health assessment attended a follow-up appointment. However, among veterans who received a PTSD diagnosis, 22% had only one mental health visit and only 41% received minimally adequate care. The findings are a call to action, the authors said.

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Citations
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Journal ArticleDOI

Psychotherapy for Military-Related PTSD: A Review of Randomized Clinical Trials.

TL;DR: In military and veteran populations, trials of the first-line trauma-focused interventions CPT and prolonged exposure have shown clinically meaningful improvements for many patients with PTSD, however, nonresponse rates have been high, many patients continue to have symptoms, and trauma- focused interventions show marginally superior results compared with active control conditions.
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Internet-based interventions for posttraumatic stress: A meta-analysis of randomized controlled trials.

TL;DR: Results for CBT-IBIs are promising, but the number of includable studies for subgroup analyses was low, limiting statistical power, and future research is necessary to systematically investigate the impact of treatment components and test against active controls with optimal power.
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The problem of dropout from "gold standard" PTSD therapies.

TL;DR: It is suggested that the term “gold-standard” evidence-based treatments should be reserved for treatments that evidence both positive results in RCTs but also feasibility and strong retention in real-world settings.
References
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Journal ArticleDOI

Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care.

TL;DR: In this paper, the authors studied the mental health of four U.S. combat infantry units (three Army units and one Marine Corps unit) using an anonymous survey that was administered to the subjects either before their deployment to Iraq (n=2530) or three to four months after their return from combat duty in Iraq or Afghanistan (n =3671).
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Psychometric properties of the PTSD Checklist (PCL).

TL;DR: The psychometric properties of the PTSD Checklist, a new, brief, self-report instrument, were determined on a population of 40 motor vehicle accident victims and sexual assault victims using diagnoses and scores from the CAPS as the criteria to support the value of the PCL as a brief screening instrument for PTSD.
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Twelve-Month Use of Mental Health Services in the United States Results From the National Comorbidity Survey Replication

TL;DR: Most people with mental disorders in the United States remain either untreated or poorly treated, and interventions are needed to enhance treatment initiation and quality.
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Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan.

TL;DR: Combat duty in Iraq was associated with high utilization of mental health services and attrition from military service after deployment, and the deployment mental health screening program provided another indicator of the mental health impact of deployment on a population level but had limited utility in predicting the level ofmental health services that were needed after deployment.
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Longitudinal assessment of mental health problems among active and reserve component soldiers returning from the Iraq war.

TL;DR: The large clinical burden recently reported among veterans presenting to Veterans Affairs facilities seems to exist within months of returning home, highlighting the need to enhance military mental health care during this period.
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