A pilot randomized controlled trial of combined trauma-focused CBT and sertraline for childhood PTSD symptoms

J Am Acad Child Adolesc Psychiatry. 2007 Jul;46(7):811-9. doi: 10.1097/chi.0b013e3180547105.


Objective: To examine the potential benefits of adding a selective serotonin reuptake inhibitor, sertraline, versus placebo, to trauma-focused cognitive-behavioral therapy (TF-CBT) for improving posttraumatic stress disorder and related psychological symptoms in children who have experienced sexual abuse.

Method: Twenty-four 10- to 17-year-old female children and adolescents and their primary caretakers were randomly assigned to receive TF-CBT + sertraline or TF-CBT + placebo for 12 weeks.

Results: Both groups experienced significant improvement in posttraumatic stress disorder and other clinical outcomes from pre- to posttreatment with no significant group x time differences between groups except in Child Global Assessment Scale ratings, which favored the TF-CBT + sertraline group.

Conclusions: Only minimal evidence suggests a benefit to adding sertraline to TF-CBT. A drawback of adding sertraline was determining whether TF-CBT or sertraline caused clinical improvement for children with comorbid depression. Current evidence therefore supports an initial trial of TF-CBT or other evidence-supported psychotherapy for most children with PTSD symptoms before adding medication.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Child
  • Cognitive Behavioral Therapy* / methods
  • Combined Modality Therapy
  • Female
  • Humans
  • Male
  • Pilot Projects
  • Selective Serotonin Reuptake Inhibitors / therapeutic use*
  • Sertraline / therapeutic use*
  • Stress Disorders, Post-Traumatic / psychology*
  • Stress Disorders, Post-Traumatic / therapy*
  • Treatment Outcome


  • Serotonin Uptake Inhibitors
  • Sertraline