Prevention of Post Traumatic Stress Disorder by Early Treatment

NCT ID: NCT00146900

Last Updated: 2016-02-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

298 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-08-31

Study Completion Date

2008-01-31

Brief Summary

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To prospectively evaluate the effect of early treatment (cognitive therapy (CT), cognitive-behavioral therapy (CBT) and escitalopram (SSRI) in preventing the occurrence of post-traumatic stress disorder in recent survivors of traumatic events.

Detailed Description

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Consecutive civilian trauma survivors will be contacted, by phone, within five days of admission to Hadassah University Hospital in Jerusalem and asked about their early psychological responses to the event. A short telephone interview will be administered to consenting subjects, to evaluate the presence of acute stress disorder (ASD). Subjects with ASD (full or partial) and those who so desire will be invited to clinical assessment, which will take place within the next two weeks. Survivors with significant symptoms of post-traumatic stress disorder will be randomized to five arms of twelve-week long treatment: CBT, CT, SSRI/placebo and waiting list (WL) and start treatment immediately. Subjects will be allowed to decline one form of therapy. WL subjects will start therapy 12 weeks later. All subjects who had clinical interview will be interviewed again at four and seven months - and 14 months following trauma (phone interview).

Conditions

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Post-traumatic Stress Disorder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Prolonged Exposure (CBT)

Twelve 1.5 hours weekly sessions of Prolonged Exposure cognitive behavioral therapy

Group Type EXPERIMENTAL

Cognitive Behavioral Therapy

Intervention Type PROCEDURE

12 weekly 1.5 hours weekly session of cognitive behavioral therapy (Prolonged Exposure)

Cognitive Therapy

Twelve 1.5 hours weekly sessions of Cognitive Therapy without exposure to traumatic reminders.

Group Type ACTIVE_COMPARATOR

Cognitive Therapy

Intervention Type PROCEDURE

12 weekly 1.5 hours weekly session of cognitive therapy without exposure

SSRI (escitalopram)

Twenty milligrams daily of escitalopram (blinded capsules)

Group Type EXPERIMENTAL

Escitalopram

Intervention Type DRUG

Twelve weeks of treatment with Escitalopram at Max. daily dose of 20mg

Placebo

Two concealed placebo pills resembling 10mg escitalopram tablets

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type OTHER

Twelve weeks of treatment with placebo pills resembling the original Escitalopram 10mg tablets but containing no active substance

Waiting List

Twelve weeks of waiting list no intervention group

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Cognitive Behavioral Therapy

12 weekly 1.5 hours weekly session of cognitive behavioral therapy (Prolonged Exposure)

Intervention Type PROCEDURE

Cognitive Therapy

12 weekly 1.5 hours weekly session of cognitive therapy without exposure

Intervention Type PROCEDURE

Escitalopram

Twelve weeks of treatment with Escitalopram at Max. daily dose of 20mg

Intervention Type DRUG

Placebo

Twelve weeks of treatment with placebo pills resembling the original Escitalopram 10mg tablets but containing no active substance

Intervention Type OTHER

Other Intervention Names

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SSRI

Eligibility Criteria

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Inclusion Criteria

* Adults survivors of traumatic events

Exclusion Criteria

* Traumatic brain injury
* Lifetime psychosis
* Life time (prior) PTSD
* Medical conditions forbidding SSRIs
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hadassah Medical Organization

OTHER

Sponsor Role lead

Responsible Party

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Aria Shalev

Emeritus Professor of Psychiatry

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Arieh Y Shalev, M.D.

Role: PRINCIPAL_INVESTIGATOR

Hadassah Medical Organization

Yossi Israeli - Shalev, M.A.

Role: STUDY_DIRECTOR

Hadassah Medical Organization

Locations

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Hadassah Medical Organization Jerusalem Israel

Jerusalem, , Israel

Site Status

Countries

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Israel

References

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Shalev AY, Ankri YL, Peleg T, Israeli-Shalev Y, Freedman S. Barriers to receiving early care for PTSD: results from the Jerusalem trauma outreach and prevention study. Psychiatr Serv. 2011 Jul;62(7):765-73. doi: 10.1176/ps.62.7.pss6207_0765.

Reference Type RESULT
PMID: 21724790 (View on PubMed)

Shalev AY, Ankri Y, Israeli-Shalev Y, Peleg T, Adessky R, Freedman S. Prevention of posttraumatic stress disorder by early treatment: results from the Jerusalem Trauma Outreach And Prevention study. Arch Gen Psychiatry. 2012 Feb;69(2):166-76. doi: 10.1001/archgenpsychiatry.2011.127. Epub 2011 Oct 3.

Reference Type RESULT
PMID: 21969418 (View on PubMed)

Bertolini F, Robertson L, Bisson JI, Meader N, Churchill R, Ostuzzi G, Stein DJ, Williams T, Barbui C. Early pharmacological interventions for prevention of post-traumatic stress disorder (PTSD) in individuals experiencing acute traumatic stress symptoms. Cochrane Database Syst Rev. 2024 May 20;5(5):CD013613. doi: 10.1002/14651858.CD013613.pub2.

Reference Type DERIVED
PMID: 38767196 (View on PubMed)

Bertolini F, Robertson L, Bisson JI, Meader N, Churchill R, Ostuzzi G, Stein DJ, Williams T, Barbui C. Early pharmacological interventions for universal prevention of post-traumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2022 Feb 10;2(2):CD013443. doi: 10.1002/14651858.CD013443.pub2.

Reference Type DERIVED
PMID: 35141873 (View on PubMed)

van der Mei WF, Barbano AC, Ratanatharathorn A, Bryant RA, Delahanty DL, deRoon-Cassini TA, Lai BS, Lowe SR, Matsuoka YJ, Olff M, Qi W, Schnyder U, Seedat S, Kessler RC, Koenen KC, Shalev AY; International Consortium to Predict PTSD. Evaluating a screener to quantify PTSD risk using emergency care information: a proof of concept study. BMC Emerg Med. 2020 Mar 2;20(1):16. doi: 10.1186/s12873-020-00308-z.

Reference Type DERIVED
PMID: 32122334 (View on PubMed)

Shalev AY, Ankri Y, Gilad M, Israeli-Shalev Y, Adessky R, Qian M, Freedman S. Long-term outcome of early interventions to prevent posttraumatic stress disorder. J Clin Psychiatry. 2016 May;77(5):e580-7. doi: 10.4088/JCP.15m09932.

Reference Type DERIVED
PMID: 27135249 (View on PubMed)

Other Identifiers

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MH-

Identifier Type: -

Identifier Source: secondary_id

21-27.06.03-HMO-CTIL

Identifier Type: -

Identifier Source: org_study_id

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