Medication versus trauma-focused psychotherapy for adults with posttraumatic stress disorder: A systematic review and meta-analysis.

Autor: Sonis J; Department of Social Medicine, CB#7240 School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, N.C., USA. Electronic address: jsonis@med.unc.edu., Cook JM; Department of Psychiatry, Yale University, New Haven, CT, USA.
Jazyk: angličtina
Zdroj: Psychiatry research [Psychiatry Res] 2019 Dec; Vol. 282, pp. 112637. Date of Electronic Publication: 2019 Oct 24.
DOI: 10.1016/j.psychres.2019.112637
Abstrakt: The goal of this study was to summarize evidence from head-to-head randomized trials for treatment of posttraumatic stress disorder (PTSD) in adults comparing trauma-focused psychotherapies and selective serotonin reuptake inhibitors (SSRIs) or serotonin/norepinephrine reuptake inhibitors (SNRIs) in a systematic review and meta-analysis. We conducted a search of multiple databases to identify trials comparing a trauma-focused psychotherapy (cognitive behavioral therapy, prolonged exposure, cognitive therapy, cognitive processing therapy or eye movement desensitization and reprocessing) to an SSRI or SNRI. Cochrane Risk of Bias 2.0 was used to assess risk of bias; high risk of bias trials were included only in sensitivity analyses. PTSD symptom reduction was the primary outcome. Four trials met inclusion criteria. Random effects meta-analysis of the two trials that were not high risk of bias showed no difference in PTSD symptom reduction, but a wide confidence interval, including effects favoring psychotherapy and effects favoring medication. Heterogeneity was high. Inclusion of the two high risk of bias trials did not change substantive conclusions. There is insufficient evidence to determine whether SSRIs or trauma-focused psychotherapies are more effective for PTSD symptom reduction among adults with PTSD.
(Copyright © 2019 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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