Seyed Amir Hossein Batouli, Foroogh Razavi, Minoo Sisakhti, Zeinab Oghabian, Haady Ahmadzade, Mehdi Tehrani Doost
Examining the Dominant Presence of Brain Grey Matter in Autism During Functional Magnetic Resonance Imaging
Basic and clinical neuroscience
guided selfhelp shown effective mental conditions effective posttraumatic stress disorder would offer timeefficient accessible treatment option potential reduce waiting times costs determine traumafocused guided selfhelp noninferior individual facetoface cognitivebehavioural therapy trauma focus mild moderate posttraumatic stress disorder single traumatic event multicentre pragmatic randomised controlled noninferiority trial economic evaluation determine costeffectiveness nested process evaluation assess fidelity adherence dose factors influence outcome including context acceptability facilitators barriers measured qualitatively participants randomised 1 1 ratio primary analysis intention treat using multilevel analysis covariance primary secondary mental health settings across united kingdoms national health service one hundred ninetysix adults primary diagnosis mild moderate posttraumatic stress disorder randomised 82 retention 16 weeks 71 52 weeks nineteen participants ten therapists interviewed process evaluation 12 facetoface manualised individual cognitivebehavioural therapy trauma focus sessions lasting 6090 minutes guided selfhelp using spring eightstep online guided selfhelp programme based cognitivebehavioural therapy trauma focus five facetoface meetings 3 hours total four brief telephone calls email contacts sessions primary outcome clinicianadministered ptsd scale diagnostic statistical manual mental disorders fifth edition 16 weeks postrandomisation secondary outcomes included severity posttraumatic stress disorder symptoms 52 weeks functioning symptoms depression symptoms anxiety alcohol use perceived social support 16 52 weeks postrandomisation assessing outcomes blinded group assignment noninferiority demonstrated primary end point 16 weeks clinicianadministered ptsd scale diagnostic statistical manual mental disorders fifth edition mean difference 101 onesided 95 ci 390 noninferiority p 0012 clinicianadministered ptsd scale diagnostic statistical manual mental disorders fifth edition score improvements 60 groups maintained 52 weeks noninferiority results inconclusive favour cognitivebehavioural therapy trauma focus timepoint mean difference 320 onesided 95 confidence interval 600 noninferiority p 015 guided selfhelp using spring shown costeffective facetoface cognitivebehavioural therapy trauma focus although significant difference accruing qualityadjusted lifeyears incremental qualityadjusted lifeyears 004 95 confidence interval 010 001 guided selfhelp using spring significantly cheaper deliver 277 95 confidence interval 253 301 vs 729 95 ci 671 788 guided selfhelp using spring appeared acceptable well tolerated participants important adverse events side effects identified results generalisable people posttraumatic stress disorder one traumatic event guided selfhelp using spring mild moderate posttraumatic stress disorder single traumatic event appears noninferior individual facetoface cognitivebehavioural therapy trauma focus results suggest considered firstline treatment people condition work needed determine best effectively disseminate implement guided selfhelp using spring scale trial registered isrctn13697710 award funded national institute health care research nihr health technology assessment programme nihr award ref 1419297 published full health technology assessment vol 27 26 see nihr funding awards website award information