In a secondary analysis of data from the TSOS study pooled with data from 2 other comparative effectiveness trials, baseline patient clinical and demographic characteristics were associated with persistent symptoms of posttraumatic stress disorder (PTSD) and diminished treatment response. The report was published online ahead of print in Psychiatry.
The TSOS study, an NIH Collaboratory Trial led by principal investigator Doug Zatzick of the University of Washington, was a stepped-wedge, cluster randomized pragmatic clinical trial testing the delivery of a stepped collaborative care intervention vs usual care for injured patients with PTSD symptoms and comorbid conditions.
In the new analysis, a subgroup of injured trauma survivors developed persistent PTSD symptoms after hospital admission and were less likely than other patients to respond to stepped care interventions. Patients with 3 or more of the baseline risk characteristics identified in the analysis were significantly less likely to engage in treatment and required more clinician time. The baseline risk characteristics included greater early PTSD symptoms, greater numbers of pre-injury trauma, pre-injury PTSD symptoms, race other than White, and unemployment.
TSOS was supported within the NIH Pragmatic Trials Collaboratory by a cooperative agreement from the National Institute of Mental Health and by the NIH Common Fund through a cooperative agreement from the Office of Strategic Coordination within the Office of the NIH Director. Learn more about the NIH Collaboratory Trials.