ArticlePCN reports : psychiatry and clinical neurosciences2026
Treatment discontinuation in a post-disaster outpatient clinic: A retrospective cohort study of post-traumatic stress disorder and complex post-traumatic stress disorder in Fukushima, Japan.
Article in PCN reports : psychiatry and clinical neurosciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Aim: Trauma-focused psychotherapies are recommended as first-line treatments for post-traumatic stress disorder (PTSD); however, treatment discontinuation remains a major challenge in routine clinical practice. This study examined treatment discontinuation and structured psychotherapy implementation among patients with PTSD and complex PTSD (CPTSD) in a post-disaster outpatient setting. Methods: This retrospective cohort study analyzed anonymized clinical records from April 2016 to March 2021 at a psychiatric outpatient clinic in Minamisoma City, Fukushima, Japan. Patients with ICD-11 PTSD or CPTSD as a primary or secondary diagnosis were included ( Results: Treatment discontinuation occurred in 33.5% (57/170) of patients within 1 year, with 64.9% of events occurring within the first 90 days. Structured psychotherapy was delivered to 17.6% (30/170) of patients. Although crude discontinuation rates differed markedly by trauma-focused psychotherapy receipt (7.1% vs. 47.4%), the association was substantially attenuated and non-significant in the time-varying analysis (hazard ratio = 0.482, 95% CI 0.113-2.050), indicating that the crude association largely reflected immortal time bias. Conclusion: In this post-disaster outpatient setting, discontinuation was concentrated in the early phase of care that precedes structured psychotherapy, and most patients never reached trauma-focused treatment. Early treatment engagement, rather than structured psychotherapy delivery alone, may represent the critical bottleneck in real-world PTSD care.
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