Post-traumatic stress symptoms as a predictor of treatment outcomes in a partial hospital program

• Published in: Journal of affective disorders reports Vol. 17; p. 100811
• Main Authors: George, Grace C., Gorman, Kaitlyn R., Seligowski, Antonia V., Beckham, Erin E., Fan, Kailyn, Björgvinsson, Thröstur, Beard, Courtney
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.07.2024; Elsevier
• Subjects: Partial hospital; Posttraumatic stress symptoms; Trauma exposure; Treatment outcome; Posttraumatic stress symptoms; Treatment outcome; Partial hospital; Trauma exposure
• ISSN: 2666-9153; 2666-9153
• DOI: 10.1016/j.jadr.2024.100811

•Trauma exposure and post-traumatic stress symptoms are highly prevalent in partial hospital systems.•Patients with severe post-traumatic stress symptoms have worse depression and anxiety symptoms at intake.•Patients with post-traumatic stress symptoms have less depression and anxiety symptom improvement at discharge.•Severe post-traumatic stress symptoms hinder symptom reduction over a partial hospital stay. Post-traumatic stress symptoms (PTSS) have been shown to negatively impact treatment outcomes in outpatient settings, but few have investigated in acute settings, such as partial hospital programs (PHP). The present study examined how PTSS may influence treatment outcomes– depression, anxiety, overall functioning– among patients attending a PHP. 1298 (Female n = 728) adults underwent standard transdiagnostic treatment at a PHP in which patients attend the day-long program for approximately 2 weeks for stabilization primarily focused on mood and anxiety symptoms. We utilized previously validated questionnaires to measure PTSD severity (PCL-5), anxiety (GAD-7), depression (PHQ-9), and overall functioning (WSAS). Linear regression analyses were conducted to determine the degree of improved symptoms and functioning across three trauma groups: patients with no trauma history, patients with trauma exposure, and patients who had severe PTSS. Patients in the PTSS group were more likely to endorse higher depression and anxiety symptoms, as well as functional impairment at admission. Severe PTSS, not trauma exposure, predicted less improvement of depression, anxiety, and overall functioning at discharge. Due to the nature of the private hospital, results may not generalize to a wider clinical population. Further, we were unable to test any potential mechanisms because the current naturalistic treatment study relied on a deidentified clinical database that was not designed with these research questions. Severe PTSS above and beyond anxiety and depression symptoms potentially serve as predictors of treatment outcomes in acute psychiatric settings such as PHPs, further emphasizing the need for enhanced trauma-informed care.