IMPORTANCE Posttraumatic stress disorder (PTSD) is a prevalent mental disorder, with a high risk of chronicity, comorbidity, and functional impairment; PTSD is complicated to treat, and the debate on the best treatment approach is ongoing. OBJECTIVE To examine comparative outcomes and acceptability of psychotherapeutic and pharmacological treatments and their combinations in adults with PTSD.

It has been shown that approximately 40% of acutely ill patients presenting for admission to the mental health service in Central Manchester can be treated in tbeday hospital as an alternative to inpatient treatment (Creed et al 1990) . The aim of !his study is to evaluate !he cost effectiveness of the two types of treatment. The evaluation is based on a randomised controlled trial conducted at Manchester Royal Infirmary. The effectiveness of treatment. measured in terms of clinical improvement, reduction in seventy of symptoms and improvement in social functioning over twelve months was the same for day hospital and in-patient care. The costs of care for patients in the study were estimated for one year following admission. by identifying and valuing the services received by each patient. The total average cost of care is significantly less for patients in the day hospital group (£3.080) than patients in the in-patientgroup (£6.07S)(p