A prospective, observational program evaluation of hyperbaric oxygen therapy for veterans with posttraumatic stress disorder.

Objective: The objective of this program evaluation was to evaluate the effects of hyperbaric oxygen therapy (HBOT) on posttraumatic stress disorder (PTSD) symptoms in U.S. veterans.Method: A prospective, singlearm, longitudinal design was used for this program evaluation.Eighty-seven veterans receiving HBOT at three Florida treatment centers were invited to complete anonymous online surveys.PTSD symptoms were assessed with the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders, fifth edition.Participants were White (90%), male (90%), and aged 30-59 years (76%).Results: Fifty veterans (57%) completed baseline, midpoint, and posttreatment surveys.Mean PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, scores decreased from 51.00 to 20.62 (Cohen's d = -1.91,95% confidence intervals [-2.5, -1.4]), reflecting a clinically significant reduction from diagnostic to subthreshold levels.Improvements were sustained at 1-, 3-, and 6-month follow-ups.HBOT was also associated with reductions in depression, anxiety, somatization, sleep disturbance, impulsivity, and stress, alongside increases in resilience and positive ideation.Conclusion: HBOT produced durable, clinically, and statistically significant reductions in PTSD symptoms (mean difference > 10, p < .001).Findings support the need for rigorous controlled trials to further examine HBOT as a potential treatment for PTSD in veterans. Clinical Impact StatementThis was a program evaluation of hyperbaric oxygen therapy, which involves breathing 100% oxygen in a pressurized chamber, administered by community providers to veterans with symptoms indicative of a diagnosis of posttraumatic stress disorder.There were clinically significant reductions in posttraumatic stress disorder symptoms for the 50 participants who completed the program, and importantly, these improvements were maintained for at least 6 months after treatment.While these results suggest the treatment is effective, it will be critical to perform a more rigorous controlled clinical trial with a larger sample size to definitively determine the extent to which this treatment works.