A randomized controlled trial of cognitive analytic versus compassion-focused therapy for PTSD in Iran-Iraq War...

Posttraumatic stress disorder (PTSD) is a common debilitating mental illness with a substantial burden on individuals and society. The authors aimed to compare the effects of cognitive analytic therapy and compassion-focused therapy on PTSD.

This was a randomized controlled trial with three parallel arms conducted from February 2022 to February 2023 in an outpatient clinic of a university hospital. Forty-five war Veterans with a confirmed diagnosis of PTSD were included. The primary outcome was a re-experiencing score, and the secondary outcomes were avoidance, hyperarousal, depression, anxiety, and numbness scores. The cognitive analytic therapy group attended a weekly 12-session program, while the compassion-focused therapy group attended a weekly 8-session program. The control group received treatment as usual.

Both intervention groups showed significant favourable changes in all study outcomes compared with the control group (all p < 0.001). However, there were significant differences between the two therapies in the mean difference of avoidance (8.4 [2.0] vs. 5.1 [1.3], p < 0.001, d = 2.18), ]and depression (11.3 [3.3] vs. 8.5 [1.8, p = 0.008, d = 1.24) from baseline to the end of the study in favour of compassion-focused therapy. All effect sizes were large for both interventions, indicating clinically important improvements.

Both cognitive analytic therapy and compassion-focused therapy are effective in treating posttraumatic stress disorder, PTSD. However, compassion-focused therapy is more effective in reducing avoidance and depression.