[Diagnosis of Posttraumatic Stress Disorder (PTSD) by the Structured Clinical Interview SCID-I]. / Diagnoza pourazowego zaburzenia stresowego (PTSD) za pomoca ustrukturalizowanego wywiadu klinicznego SCID-I.

OBJECTIVES: Valid and reliable diagnosis of posttraumatic stress disorder is important for clinical practice, scientific research and forensic settings. The aim of the study was to assess the psychometric properties of the Polish version of SCID-I F Module for the diagnosis of PTSD. METHODS: Five hundred twenty six motor vehicle accident survivors participated in the study. Clinical diagnosis was based on SCID-I-PTSD interview. Participants filled out a set of self-report inventories concerning PTSD symptoms (PDS), depression (BDI-II), anxiety (STAI) and posttraumatic cognitions (PTCI). RESULTS: The interview assessment showed high reliability and both convergent and discriminative validity. SCID-I-PTSD interview proved to be more specific than PDS inventory. Interview items show good psychometric properties (except an item C3) and no differential item functioning for sex. Latent structure analysis of PTSD symptoms were nonconclusive. CONCLUSIONS: A part of Module F of the SCID-I, a structured clinical interview for the assessment of posttraumatic stress disorder is a valid and reliable psychometric tool useful for the diagnosis of PTSD.

Prolonged exposure, paroxetine and the combination in the treatment of PTSD following a motor vehicle accident. A randomized clinical trial - The "TRAKT" study.

BACKGROUND AND OBJECTIVE: Little is known about direct comparisons of the efficacy of trauma-focused psychotherapies and SSRIs. This is the first randomized clinical trial comparing the efficacy of prolonged exposure (PE), paroxetine (Ph) and their combination (Comb) in a sample of adults diagnosed with PTSD following motor vehicle accidents (MVA). METHODS: A total of 228 people were randomly assigned to a twelve-week treatment of PE (N = 114), Ph (N = 57) or Comb (N = 57). RESULTS: The ITT analyses showed that the remission rate of PTSD was significantly greater after PE (65.5%) compared with Ph (43.3%), whereas Comb (51.2%) did not differ from either. The differences in dropout rates were not significant between treatments (18.4% - PE; 12.2% - Ph; 22.8% - Comb), while the differences in numbers of refusers were significant (3.5% PE <31.6% Comb <47.4% Ph; p < .01). The changes in self-rated PTSD were significant for each treatment and without significant differences between treatments. Differences between clinician and self-rated outcomes can be explained by depressive symptoms influencing self-rating by the PDS. At a 12 month follow-up treatment results were maintained and different trajectories of functioning were identified. LIMITATIONS: Larger samples would allow analyses of predictors of treatment response, dropout and refusal. CONCLUSIONS: In this, largest to date study comparing PE, paroxetine and combination treatment in PTSD PE was more effective than Ph in achieving remission of PTSD. The additive effect of Comb over any monotherapy was not shown.