Mantram repetition trumps present-centred therapy in reducing PTSD symptoms in veterans
Individual treatment of veterans with post-traumatic stress disorder (PTSD) using mantram repetition, a nontrauma-focused complementary therapy, is more effective than present-centred therapy for reducing PTSD symptom severity and insomnia, reports a study.
Improvements in the Clinician-Administered PTSD Scale (CAPS) score were significantly greater in the mantram group vs the present-centred therapy group both at the post-treatment assessment (between-group difference across time, –9.98; –3.63 to –16.00; d=0.49) and at the 2-month follow-up (between-group difference, –9.34; 1.50 to –17.18; d=0.46).
The mantram group also had lower self-reported PTSD symptom severity compared with the present-centred therapy group at the post-treatment assessment. However, no difference was observed at the 2-month follow-up.
Compared with the present-centred therapy group, significantly more patients in the mantram group who completed the 2-month follow-up no longer met the criteria for PTSD (59 percent vs 40 percent; p<0.04). However, there were no significant between-group difference in the percentage of participants who had clinically meaningful changes (≥10-point improvements) in CAPS score (75 percent vs 61 percent).
Furthermore, significantly more patients in the mantram group had reductions in insomnia at both post-treatment assessment and 2-month follow-up.
In this two-site, open-allocation, blinded-assessment randomized trial, 173 veterans with military-related PTSD from two Veterans Affairs outpatient clinics (January 2012 to March 2014) were included. Participants in the mantram group (n=89) learned skills for silent mantram repetition, slowing thoughts and one-pointed attention. Those in the comparison group (n=84) received present-centred therapy, focusing on currently stressful events and problem-solving skills. Both treatments were delivered per individual in eight weekly 1-hour sessions.
Change in PTSD symptom severity, as measured by the CAPS and by self-report, was the primary outcome measure. Secondary outcome measures were insomnia, depression, anger, spiritual well-being, mindfulness and quality of life. The authors used linear mixed models to perform intent-to-treat analysis.