Healthcare cost reduction and psychiatric symptom improvement in posttraumatic stress disorder patients treated with intensive short-term dynamic psychotherapy - 10/10/19

Doi : 10.1016/j.ejtd.2019.100122

Hannah Roggenkamp ^a,^b,⁎ , Allan Abbass ^c , Joel M. Town ^c , Steve Kisely ^c,^d,^e , Robert Johansson ^f
^a Trauma Recovery Services, Department of Mental Health, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd Building 401, 90073 Los Angeles, CA, USA
^b Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, 760 Westwood Plaza, 90095 Los Angeles, CA, USA
^c Centre for Emotions & Health, Department of Psychiatry, Dalhousie University, 5909 Veterans’ Memorial Lane, 8th Floor, QEII Health Sciences Centre, B3H 2E2 Halifax, NS, Canada
^d School of Medicine, The University of Queensland, 288 Herston Road, 4006 Herston QLD, Australia
^e Departments of Psychiatry, Community Health & Epidemiology, Dalhousie University, 5909 Veterans’ Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, B3H 2E2 Halifax, NS, Canada
^f Department of Psychology, Stockholm University, 10691 Stockholm, Sweden

^⁎Corresponding author at: VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd Building 401, 90073 Los Angeles, CA, USA.VA Greater Los Angeles Healthcare System11301 Wilshire Blvd Building 401Los Angeles, CA90073USA

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Thursday 10 October 2019
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Abstract

Introduction

Posttraumatic stress disorder (PTSD) is associated with significant psychiatric morbidity and high healthcare costs.

Objective

The aim of this pilot study was to evaluate changes in healthcare costs and general psychiatric symptom severity in patients with PTSD following intensive short-term dynamic psychotherapy (ISTDP).

Method

Healthcare services cost and utilization data were compiled at intake, prior to starting ISTDP and then assessed annually for three years thereafter. Two validated self-report scales, the Brief Symptom Inventory and the Inventory of Interpersonal Problems, were administered at intake and termination.

Results

Results showed significant reductions in physician costs and physician visits at one-year post-treatment, with these persisting over the three-year follow-up period. There were also large but statistically non-significant reductions in hospital costs. At termination, self-reported psychiatric symptoms and interpersonal problems were reduced.

Conclusion

These preliminary findings suggest that ISTDP may lead to healthcare cost reductions and general psychiatric symptom improvement in patients with PTSD, with healthcare utilization benefits maintained at long-term follow up. Future research directions were discussed.

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Keywords : Posttraumatic stress disorder, Psychotherapy, Psychodynamic, Healthcare costs, Comorbidity, Pilot project