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The purpose of this study was to assess treatment outcome among 23 severely traumatized Cambodian refugee patients with posttraumatic stress disorder who had been in continuous treatment for 10 or more years. Primary outcome parameters were symptom severity, social and vocational disability, and subjective quality of life. All patients were interviewed using standard assessment tools by a research psychiatrist not connected with the treatment, and charts were reviewed for past and current traumas and for treatment history. There was a wide range of current posttraumatic stress disorder symptom scores, but current depression scores were very low. Thirteen patients were judged to have good outcomes, and 10 had relatively poor outcomes. Reported degree of previous trauma and demographic factors did not distinguish between the two outcome groups. Sixty percent of patients greatly improved. However, even with comprehensive continuous treatment over a period of 10 or more years, a substantial minority was still impaired.