The effects of war on combatants and those who directly witness it can persist long after peace has been restored and troops have returned home. In Canada, it is estimated that 10% of war zone veterans will develop post-traumatic stress disorder (PTSD) while others will exhibit at least some of its symptoms.
Treating PTSD can be difficult because it is a protean disorder that manifests itself differently in each person. For some patients, in-patient treatment is most appropriate, while outpatient care works best for others. Still others will respond better to a combination of the two approaches.
Differences between veterans and active military personnel
Professor Marcantoni and his team at CIUSSS of the West Island of Montreal analyzed 32 studies investigating the treatment of PTSD in active military personnel and veterans who received inpatient or SAI care. The majority of studies were conducted in the United States, with the remainder in the United Kingdom, Australia and Israel.
All patients studied had symptoms of PTSD, with many also having comorbidities such as depression, anxiety, drug and alcohol abuse.
Both inpatient care and SAI included various forms of psychotherapy – usually delivered in a group setting – including cognitive processing therapy and cognitive behavioral therapy. Both approaches also used complementary therapies, such as psychoeducation, anger management, drug therapy management and art therapy.
“What we found, whether the patient was followed in the hospital setting or receiving SAI, you see basically the same changes in the actions taken between the first appointment and discharge. There is no real difference,” explains Professor Marcantoni, who is responsible for the CIUSS health technology and intervention methods evaluation unit.
The research team noted a significant difference between the outcomes of patients treated by private SAI clinics and those treated by clinics run by the U.S. Department of Defense. According to his observations, private clinics mainly treat veterans, while government clinics only accept active military personnel.
“We can only speculate at the moment, but it seems that SAIs are more suitable for veterans than for active military personnel,” continues Professor Marcantoni. Several reasons can explain this observation: various prejudices still accompany the fact of undergoing treatment and, in the case of active military personnel, treatment is generally not followed voluntarily, but following an order. However, veterans who decide to receive such treatment do so entirely of their own volition – they do it because they want to. »
