Early trauma-focused cognitive-behavioural therapy to prevent chronic post-traumatic stress disorder and related symptoms: A systematic review and meta-analysis

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.

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Cognitive-Behavioural Therapy and Psychodynamic Psychotherapy in the Treatment of Combat-Related Post-Traumatic Stress Disorder: A Comparative Effectiveness Study

Clinical Psychology & Psychotherapy ◽

10.1002/cpp.1969 ◽

2015 ◽

Vol 23 (4) ◽

pp. 298-307 ◽

Cited By ~ 21

Author(s):

Ofir Levi ◽

Yair Bar-Haim ◽

Yitshak Kreiss ◽

Eyal Fruchter

Keyword(s):

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Comparative Effectiveness ◽

Psychodynamic Psychotherapy ◽

Stress Disorder ◽

Behavioural Therapy ◽

Post Traumatic Stress ◽

Cognitive Behavioural ◽

Comparative Effectiveness Study ◽

Post Traumatic

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The effect of flexible cognitive–behavioural therapy and medical treatment, including antidepressants on post-traumatic stress disorder and depression in traumatised refugees: pragmatic randomised controlled clinical trial

The British Journal of Psychiatry ◽

10.1192/bjp.bp.114.150961 ◽

2016 ◽

Vol 208 (3) ◽

pp. 252-259 ◽

Cited By ~ 44

Author(s):

Caecilie Böck Buhmann ◽

Merete Nordentoft ◽

Morten Ekstroem ◽

Jessica Carlsson ◽

Erik Lykke Mortensen

Keyword(s):

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Stress Disorder ◽

Behavioural Therapy ◽

Controlled Clinical Trial ◽

Post Traumatic Stress ◽

Cognitive Behavioural ◽

Randomised Controlled Clinical Trial ◽

Post Traumatic ◽

Randomised Controlled

BackgroundLittle evidence exists on the treatment of traumatised refugees.AimsTo estimate treatment effects of flexible cognitive–behavioural therapy (CBT) and antidepressants (sertraline and mianserin) in traumatised refugees.MethodRandomised controlled clinical trial with 2×2 factorial design (registered with Clinicaltrials.gov, NCT00917397, EUDRACT no. 2008-006714-15). Participants were refugees with war-related traumatic experiences, post-traumatic stress disorder (PTSD) and without psychotic disorder. Treatment was weekly sessions with a physician and/or psychologist over 6 months.ResultsA total of 217 of 280 patients completed treatment (78%). There was no effect on PTSD symptoms, no effect of psychotherapy and no interaction between psychotherapy and medicine. A small but significant effect of treatment with antidepressants was found on depression.ConclusionsIn a pragmatic clinical setting, there was no effect of flexible CBT and antidepressants on PTSD, and there was a small-to-moderate effect of antidepressants and psychoeducation on depression in traumatised refugees.

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