scholarly journals Global burden of post-traumatic stress disorder and major depression in countries affected by war between 1989 and 2019: a systematic review and meta-analysis

2021 ◽  
Vol 6 (7) ◽  
pp. e006303
Author(s):  
Thole H Hoppen ◽  
Stefan Priebe ◽  
Inja Vetter ◽  
Nexhmedin Morina
Keyword(s):  
Major Depression ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Meta Analysis ◽  
Global Burden ◽  
Post Traumatic Stress ◽  
Low Middle Income Countries ◽  
War Survivors ◽  
Post Traumatic

ObjectiveExtensive research has demonstrated high prevalences of post-traumatic stress disorder (PTSD) and major depression (MD) in war-surviving populations. However, absolute estimates are lacking, which may additionally inform policy making, research and healthcare. We aimed at estimating the absolute global prevalence and disease burden of adult survivors of recent wars (1989–2019) affected by PTSD and/or MD.MethodsWe conducted a systematic literature search and meta-analysis of interview-based epidemiological surveys assessing the prevalence of PTSD and/or MD in representative samples from countries with a recent war history (1989–2019). Drawing on the war definition and geo-referenced data of the Uppsala Conflict Database Programme and population estimates of the United Nations for 2019, we extrapolated the meta-analytic results to absolute global numbers of affected people. Drawing on disability-adjusted life years (DALYs) data of the Global Burden of Diseases Study 2019, we further calculated the PTSD-associated and MD-associated DALYs.ResultsTwenty-two surveys (N=15 420) for PTSD, 13 surveys for MD (N=9836) and six surveys on the comorbidity of PTSD and MD (N=1131) were included. Random effects meta-analyses yielded point prevalences of 26.51% for PTSD and 23.31% for MD. Of those affected by PTSD, 55.26% presented with comorbid MD. Prevalence rates were not significantly associated with war intensity and length, time since war, response rate or survey quality. The extrapolation yielded 316 million adult war-survivors globally who suffered from PTSD and/or MD in 2019. War-survivors were almost exclusively living in low/middle-income countries (LMICs) and carried a burden of 3 105 387 and 4 083 950 DALYs associated with PTSD and MD, respectively.ConclusionsSince LMICs lack sufficient funding and qualified professionals to provide evidence-based psychological treatments for such large numbers of affected people, alternative and scalable strategies using existing resources in primary care and communities are required. Research is required to assist upscaling.

scholarly journals Pharmacotherapy for post-traumatic stress disorder: Systematic review and meta-analysis

2015 ◽  
Vol 206 (2) ◽  
pp. 93-100 ◽  
Author(s):  
Mathew Hoskins ◽  
Jennifer Pearce ◽  
Andrew Bethell ◽  
Liliya Dankova ◽  
Corrado Barbui ◽  
...  
Keyword(s):  
Systematic Review ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Stress Disorder ◽  
Positive Impact ◽  
Meta Analysis ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Post Traumatic

BackgroundPharmacological treatment is widely used for post-traumatic stress disorder (PTSD) despite questions over its efficacy.AimsTo determine the efficacy of all types of pharmacotherapy, as monotherapy, in reducing symptoms of PTSD, and to assess acceptability.MethodA systematic review and meta-analysis of randomised controlled trials was undertaken; 51 studies were included.ResultsSelective serotonin reuptake inhibitors were found to be statistically superior to placebo in reduction of PTSD symptoms but the effect size was small (standardised mean difference −0.23, 95% CI −0.33 to −0.12). For individual pharmacological agents compared with placebo in two or more trials, we found small statistically significant evidence of efficacy for fluoxetine, paroxetine and venlafaxine.ConclusionsSome drugs have a small positive impact on PTSD symptoms and are acceptable. Fluoxetine, paroxetine and venlafaxine may be considered as potential treatments for the disorder. For most drugs there is inadequate evidence regarding efficacy for PTSD, pointing to the need for more research in this area.

scholarly journals Prevalence of suicidality, depression, post-traumatic stress disorder, and anxiety among female sex workers: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Juan Manuel Millan-Alanis ◽  
Farid Carranza-Navarro ◽  
Humberto de León-Gutiérrez ◽  
Paloma C. Leyva-Camacho ◽  
Andrea Fernanda Guerrero-Medrano ◽  
...  
Keyword(s):  
Systematic Review ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Stress Disorder ◽  
Meta Analysis ◽  
Post Traumatic Stress ◽  
Female Sex ◽  
Post Traumatic

The Prevalence of Post-Traumatic Stress Disorder in Birth Parents in Child Protection Services: Systematic Review and Meta-analysis

2021 ◽  
pp. 152483802110484
Author(s):  
Aino Suomi ◽  
Annalese Bolton ◽  
Dave Pasalich
Keyword(s):  
Mental Health ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Child Protection ◽  
Stress Disorder ◽  
Meta Analysis ◽  
Post Traumatic Stress ◽  
Birth Parents ◽  
Child Protection Services ◽  
Post Traumatic

Background Birth parents of children in the statutory child protection system have disproportionally high rates of trauma exposure and mental health problems, however, little is known about the extent to which this population display symptoms of Post-Traumatic Stress Disorder (PTSD) or Complex PTSD. This study provides a systematic review and meta-analysis of the PTSD rates in parent samples involved in the child protection services. Method Articles were identified by searching PSYCINFO, Medline, CINAHL, and PILOTS. The search included terminology pertaining to parents, trauma, and child protective services and we included all peer-reviewed articles that reported a valid measure of PTSD and child protection service involvement. Results Fifteen studies were included in the review with a combined prevalence estimate for PTSD based on 11 studies ( n = 4871) was 26.0% (95% CI 20.0–32.0%) for mothers, and estimate based on three studies ( n = 2606) was 13.0% (95% CI 7.0%–18.0%) for fathers and 23.0% (95% CI 17.0–29.0) for all parents based on 7848 responses. Four studies that did not report prevalence rates, reported sample mean scores for PTSD that were consistently higher than in general population. Factors associated with parents’ PTSD symptoms included mental health co-morbidities, victimization of physical and sexual violence, and perpetration of child abuse. Conclusion There are high rates of PTSD in parents involved in the protective system, thus more targeted efforts are needed to identify and adequately address trauma symptoms of parents as part of child protection interventions.

scholarly journals Comparative efficacy and acceptability of pharmacological treatments for post-traumatic stress disorder in adults: a network meta-analysis

2017 ◽  
Vol 48 (12) ◽  
pp. 1975-1984 ◽  
Author(s):  
Andrea Cipriani ◽  
Taryn Williams ◽  
Adriani Nikolakopoulou ◽  
Georgia Salanti ◽  
Anna Chaimani ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Meta Analysis ◽  
Dropout Rate ◽  
Pharmacological Intervention ◽  
Cochrane Central Register ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Better Than

AbstractBackgroundGuidelines about post-traumatic stress disorder (PTSD) recommend broad categories of drugs, but uncertainty remains about what pharmacological treatment to select among all available compounds.MethodsCochrane Central Register of Controlled Trials register, MEDLINE, PsycINFO, National PTSD Center Pilots database, PubMed, trial registries, and databases of pharmaceutical companies were searched until February 2016 for double-blind randomised trials comparing any pharmacological intervention or placebo as oral therapy in adults with PTSD. Initially, we performed standard pairwise meta-analyses using a random effects model. We then carried out a network meta-analysis. The main outcome measures were mean change on a standardised scale and all-cause dropout rate. Acute treatment was defined as 8-week follow up.ResultsDesipramine, fluoxetine, paroxetine, phenelzine, risperidone, sertraline, and venlafaxine were more effective than placebo; phenelzine was better than many other active treatments and was the only drug, which was significantly better than placebo in terms of dropouts (odds ratio 7.50, 95% CI 1.72–32.80). Mirtazapine yielded a relatively high rank for efficacy, but the respective value for acceptability was not among the best treatments. Divalproex had overall the worst ranking.ConclusionsThe efficacy and acceptability hierarchies generated by our study were robust against many sources of bias. The differences between drugs and placebo were small, with the only exception of phenelzine. Considering the small amount of available data, these results are probably not robust enough to suggest phenelzine as a drug of choice. However, findings from this review reinforce the idea that phenelzine should be prioritised in future trials in PTSD.

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