High rates of drop-out from treatment of PTSD have challenged implementation. Care models that integrate PTSD focused psychotherapy and complementary interventions may provide benefit in retention and outcome. The first 80 veterans with chronic PTSD enrolled in a 2-week intensive outpatient program combining Prolonged Exposure (PE) and complementary interventions completed symptom and biological measures at baseline and posttreatment. We examined trajectories of symptom change, mediating and moderating effects of a range of patient characteristics. Of the 80 veterans, 77 completed (96.3%) treatment and pre- and posttreatment measures. Self-reported PTSD (p < .001), depression (p < .001) and neurological symptoms (p < .001) showed large reductions with treatment. For PTSD, 77% (n = 59) showed clinically significant reductions. Satisfaction with social function (p < .001) significantly increased. Black veterans and those with a primary military sexual trauma (MST) reported higher baseline severity than white or primary combat trauma veterans respectively but did not differ in their trajectories of treatment change. Greater cortisol response to the trauma potentiated startle paradigm at baseline predicted smaller reductions in PTSD over treatment while greater reductions in this response from baseline to post were associated with better outcomes. Intensive outpatient prolonged exposure combined with complementary interventions shows excellent retention and large, clinically significant reduction in PTSD and related symptoms in two weeks. This model of care is robust to complex presentations of patients with varying demographics and symptom presentations at baseline. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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为患有创伤后应激障碍的退伍军人提供长期暴露的强化门诊计划：保留、预测因素和变化模式。

PTSD 治疗的高辍学率对实施提出了挑战。整合 PTSD 重点心理治疗和补充干预的护理模式可能会在保留和结果方面提供好处。首批 80 名患有慢性 PTSD 的退伍军人参加了为期 2 周的强化门诊计划，该计划结合了长期暴露 (PE) 和补充干预措施，完成了基线和治疗后的症状和生物学测量。我们检查了一系列患者特征的症状变化轨迹、中介和调节作用。在 80 名退伍军人中，77 名（96.3%）完成了治疗和治疗前后的措施。自我报告的 PTSD (p < .001)、抑郁 (p < .001) 和神经系统症状 (p < .001) 显示治疗后大幅减少。对于 PTSD，77% (n = 59) 显示临床显着减少。对社会功能的满意度 (p < .001) 显着增加。黑人退伍军人和那些有原发性军事性创伤 (MST) 的人报告的基线严重程度分别高于白人或初级战斗创伤退伍军人，但他们的治疗变化轨迹没有差异。基线时对创伤增强惊吓范式的更大皮质醇反应预示着治疗后 PTSD 的减少较小，而这种反应从基线到后期的更大减少与更好的结果相关。强化门诊长期暴露与补充干预相结合，显示出良好的保留效果，并在两周内大大减少了 PTSD 和相关症状。这种护理模式对于基线时具有不同人口统计学和症状表现的患者的复杂表现是稳健的。