***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE  Sleep disturbance  is highly prevalent among veterans . As an alternative to sleep medications with their undesirable side effects , nonpharmacological mind-body interventions may be beneficial for sleep management in primary care . The aim of this pilot study was to investigate whether a novel mind-body intervention , mind-body bridging ( MBB ) , focusing on sleep , could improve self-reported sleep disturbance and comorbid symptoms in veterans . METHODS This pilot study was a r and omized controlled trial at the Veterans Affairs Salt Lake City Health Care System in which 63 veterans with self-reported sleep disturbance received MBB or an active sleep education control .  Both interventions were conducted in two sessions , once per week . Patient-reported outcomes included the following : primary -Medical Outcomes Study ( MOS ) Sleep Survey , MOS Short Form-36V ; secondary -Center for Epidemiological Studies -Depression , PTSD Check List-Military , Five-Factor Mindfulness Question naire . RESULTS At both Week 1 ( 1 week after the first session ) and post-intervention assessment s , while sleep disturbance decreased in both groups , MBB performed significantly better than did the control group . Furthermore , self-reported PTSD symptoms improved in MBB , while they remained unchanged in the control . Overall mindfulness increased in MBB , while it remained unchanged in the control . CONCLUSIONS This study provides preliminary evidence that a brief sleep-focused MBB could be a promising intervention for sleep and potentially other comorbid symptoms ( e.g. , PTSD ) . MBB could help patients develop awareness skills to deal with sleep-related symptoms . Integration of MBB into primary care setting s may enhance care of patients with sleep disturbance and co-morbid symptoms This article describes a second treatment- outcome study of cognitive trauma therapy for battered women with posttraumatic stress disorder ( PTSD ; CTT-BW ) . CTT-BW includes trauma history exploration : PTSD education ; stress management ; exposure to abuse and abuser reminders ; self-monitoring of negative self-talk ; cognitive therapy for guilt ; and modules on self-advocacy , assertiveness , and how to identify perpetrators . One hundred twenty-five ethnically diverse women were r and omly assigned to immediate or delayed CTT-BW .  PTSD remitted in 87 % of women who completed CTT-BW , with large reductions in depression and guilt and substantial increases in self-esteem .  White and ethnic minority women benefited equally from CTT-BW . Similar treatment outcomes were obtained by male and female therapists and by therapists with different levels of education and training . Gains were maintained at 3- and 6-month follow-ups Abstract This study examined the effect of Emotional Freedom Techniques ( EFT ) , a brief exposure therapy combining cognitive and somatic elements , on posttraumatic stress disorder  ( PTSD ) and  psychological distress  symptoms in veterans receiving mental health services . Veterans meeting the clinical criteria for PTSD were r and omized to EFT ( n = 30 ) or st and ard of care wait list ( SOC/WL ; n = 29 ) . The EFT intervention consisted of 6-hour – long EFT coaching sessions concurrent with st and ard care . The SOC/WL and EFT groups were compared before and after the intervention ( at 1 month for the SOC/WL group and after six sessions for the EFT group ) . The EFT subjects had significantly reduced psychological distress ( p < 0.0012 ) and PTSD symptom levels ( p < 0.0001 ) after the test . In addition , 90 % of the EFT group no longer met PTSD clinical criteria , compared with 4 % in the SOC/WL group . After the wait period , the SOC/WL subjects received EFT . In a within-subjects longitudinal analysis , 60 % no longer met the PTSD clinical criteria after three sessions . This increased to 86 % after six sessions for the 49 subjects who ultimately received EFT and remained at 86 % at 3 months and at 80 % at 6 months . The results are consistent with that of other published reports showing EFT ’s  efficacy in treating PTSD and comorbid symptoms and its long-term effects BACKGROUND Little is known about the effect of pharmacotherapy in the prevention of  post-traumatic stress disorder ( PTSD ) relapse .  AIMS To assess the efficacy and tolerability of fluoxetine in preventing PTSD relapse . METHOD This was a double-blind , r and omised , placebo-controlled study . Following 12 weeks of acute treatment , patients who responded were rer and omised and continued in a 24-week relapse prevention phase with fluoxetine ( n=69 ) or placebo ( n=62 ) . The primary efficacy assessment was the prevention of PTSD relapse , based on the time to relapse . RESULTS Patients in the fluoxetine/fluoxetine group were less likely to relapse than patients in the fluoxetine/placebo group ( P=0.027 ) . There were no clinical ly significant differences in treatment-emergent adverse events between treatment groups . CONCLUSIONS Fluoxetine is effective and well tolerated in the prevention of PTSD relapse for up to 6 months BACKGROUND Unlike civilian post-traumatic stress disorder ( PTSD ) , the efficacy of sertraline for the treatment of combat-related PTSD has not yet been proven . The present study aim ed to evaluate the clinical efficacy of sertraline against combat-related PTSD in a r and omized , double-blind , placebo-controlled trial . METHOD Seventy Iranian veterans of the Iran-Iraq war who met the DSM-IV criteria for diagnosis of PTSD were r and omized to receive either flexibly dosed sertraline ( 50 - 200 mg/day ) ( n=35 , completers=32 ) or placebo ( n=35 , completers=30 ) for 10 weeks . Efficacy was evaluated by the Impact of Event Scale -- Revised ( IES-R ) and the Clinical Global Impression scale -- Severity ( CGI-S ) and Improvement ( CGI-I ) ratings . Responder criteria were defined as a ≥30 % reduction in the IES-R total score plus a CGI-I rating of ' much ' or ' very much ' improved . RESULTS On both intention-to-treat ( ITT ) and per protocol ( completer ) methods of analysis , the mean reductions in the IES-R total and subscale ( re-experiencing/intrusion , avoidance/numbing and hyperarousal ) scores ( p<0.001 ) and also in the CGI-S score ( p<0.01 ) were significantly greater in the sertraline group than in the placebo group . For the CGI-I , the mean endpoint score was significantly lower in the sertraline group than in the placebo group ( p≤0.001 ) . The number of responders in the sertraline group was significantly higher than in the placebo group ( 44 % v. 3 % , p≤0.001 ) . Sertraline was well tolerated , with a 6 % discontinuation rate as a result of adverse reactions . CONCLUSIONS The results of this study suggest that sertraline can be an effective , safe and tolerable treatment for combat-related PTSD in Iranian veterans CONTEXT No large-scale posttraumatic stress disorder drug trials have been conducted to evaluate treatment effects beyond 12 weeks outside of those with selective serotonin reuptake inhibitors . OBJECTIVE To evaluate the efficacy of venlafaxine extended release ( ER ) , a serotonin norepinephrine reuptake inhibitor , in posttraumatic stress disorder . DESIGN 6-month , double-blind , placebo-controlled trial . SETTING International study at 56 sites . Patients Adult out patients ( N = 329 ) with a primary diagnosis of posttraumatic stress disorder as defined in the DSM-IV , symptoms for 6 months or longer , and a 17-item Clinician-Administered Posttraumatic Stress Disorder Scale score of 60 or higher . Intervention Patients r and omly assigned to receive flexible doses of venlafaxine ER ( 37.5 - 300 mg/d ) or placebo for 24 weeks . MAIN OUTCOME MEASURES Primary measure was the change from baseline in the Clinician-Administered Posttraumatic Stress Disorder Scale score . Secondary measures included remission , defined as a Clinician-Administered Posttraumatic Stress Disorder Scale score of 20 or lower , and changes in symptom cluster scores , frequency of remission , and time to remission . Measures of stress vulnerability , resilience , depression , quality of life , functioning , and global illness severity were also taken . RESULTS Mean changes from baseline in Clinician-Administered Posttraumatic Stress Disorder Scale total scores at end point were -51.7 for venlafaxine ER and -43.9 for placebo ( P = .006 ) . Improvement was significantly greater for the venlafaxine ER group than for the placebo group in cluster scores for reexperiencing ( P = .008 ) and avoidance/numbing ( P = .006 ) , but not for hyperarousal . Remission rates were 50.9 % for venlafaxine ER and 37.5 % for placebo ( P = .01 ) . The venlafaxine ER group also showed significantly greater improvement at end point than the placebo group ( P<.05 ) on all other reported outcome measures . The mean maximum daily dose of venlafaxine ER was 221.5 mg/d . Withdrawal rates were similar between groups with no significant difference in dropouts attributable to adverse events . CONCLUSION In this study , venlafaxine ER was effective and well tolerated in short-term and continuation treatment of patients with posttraumatic stress disorder IMPORTANCE Alcohol dependence comorbid with posttraumatic stress disorder ( PTSD ) has been found to be resistant to treatment . In addition , there is a concern that prolonged exposure therapy for PTSD may exacerbate alcohol use . OBJECTIVE To compare the efficacy of an evidence -based treatment for alcohol dependence ( naltrexone ) plus an evidence -based treatment for PTSD ( prolonged exposure therapy ) , their combination , and supportive counseling . DESIGN , SETTING , AND PARTICIPANTS A single-blind , r and omized clinical trial of 165 participants with PTSD and alcohol dependence conducted at the University of Pennsylvania and the Philadelphia Veterans Administration . Participant enrollment began on February 8 , 2001 , and ended on June 25 , 2009 . Data collection was completed on August 12 , 2010 . INTERVENTIONS Participants were r and omly assigned to ( 1 ) prolonged exposure therapy plus naltrexone ( 100 mg/d ) , ( 2 ) prolonged exposure therapy plus pill placebo , ( 3 ) supportive counseling plus naltrexone ( 100 mg/d ) , or ( 4 ) supportive counseling plus pill placebo . Prolonged exposure therapy was composed of 12 weekly 90-minute sessions followed by 6 biweekly sessions . All participants received supportive counseling . MAIN OUTCOMES AND MEASURES The Timeline Follow-Back Interview and the PTSD Symptom Severity Interview were used to assess the percentage of days drinking alcohol and PTSD severity , respectively , and the Penn Alcohol Craving Scale was used to assess alcohol craving . Independent evaluations occurred prior to treatment ( week 0 ) , at posttreatment ( week 24 ) , and at 6 months after treatment discontinuation ( week 52 ) . RESULTS Participants in all 4 treatment groups had large reductions in the percentage of days drinking ( mean change , -63.9 % [ 95 % CI , -73.6 % to -54.2 % ] for prolonged exposure therapy plus naltrexone ; -63.9 % [ 95 % CI , -73.9 % to -53.8 % ] for prolonged exposure therapy plus placebo ; -69.9 % [ 95 % CI , -78.7 % to -61.2 % ] for supportive counseling plus naltrexone ; and -61.0 % [ 95 % CI , -68.9 % to -53.0 % ] for supportive counseling plus placebo ) . However , those who received naltrexone had lower percentages of days drinking than those who received placebo ( mean difference , 7.93 % ; P = .008 ) . There was also a reduction in PTSD symptoms in all 4 groups , but the main effect of prolonged exposure therapy was not statistically significant . Six months after the end of treatment , participants in all 4 groups had increases in percentage of days drinking . However , those in the prolonged exposure therapy plus naltrexone group had the smallest increases . CONCLUSIONS AND RELEVANCE In this study of patients with alcohol dependence and PTSD , naltrexone treatment result ed in a decrease in the percentage of days drinking .  Prolonged exposure therapy was not associated with an exacerbation of alcohol use disorder . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00006489 A cognitive-behavioral therapy ( CBT ) program for posttraumatic stress disorder ( PTSD ) was developed to address its high prevalence in persons with severe mental illness receiving treatment at community mental health centers .  CBT was compared with treatment as usual ( TAU ) in a r and omized controlled trial with 108 clients with PTSD and either major mood disorder ( 85 % ) or schizophrenia or schizoaffective disorder ( 15 % ) , of whom 25 % also had border 
    Output:
    
The E-TRIP provides a comprehensive assessment of prior PTSD treatments that should prove valuable for research ers study ing TR-PTSD and evaluating the efficacy of new treatments for patients with PTSD .