Treatment of pharmacotherapy-refractory posttraumatic stress disorder among Cambodian refugees: a pilot study of combination treatment with cognitive-behavior therapy vs sertraline alone

Behav Res Ther. 2003 Nov;41(11):1271-6. doi: 10.1016/s0005-7967(03)00032-9.


Cambodian refugees with posttraumatic stress disorder (PTSD) represent a cohort in severe need of treatment, but little information is available to guide treatment choices. We selected a sample of pharmacotherapy-refractory individuals to test the efficacy of combination treatment with sertraline and cognitive-behavior therapy (CBT) for treating PTSD. Participants in this pilot study were ten Khmer-speaking women who had been at a mean age of 22-26 years during the Pol Pot period (1975-1979). These patients were randomly assigned to either sertraline alone or combined treatment. We found that combined treatment offered additional benefit in the range of medium to large effect sizes for PTSD and associated symptoms. Our findings indicate that substantial gains can be achieved by adding CBT to pharmacotherapy for PTSD, and that a program of CBT emphasizing information, exposure, and cognitive-restructuring can be successfully modified for Khmer-speaking refugees.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antidepressive Agents / therapeutic use*
  • Cambodia / ethnology
  • Cognitive Behavioral Therapy / methods*
  • Combined Modality Therapy
  • Female
  • Humans
  • Middle Aged
  • Pilot Projects
  • Refugees*
  • Sertraline / therapeutic use*
  • Stress Disorders, Post-Traumatic / ethnology
  • Stress Disorders, Post-Traumatic / therapy*
  • United States


  • Antidepressive Agents
  • Sertraline