Posttraumatic stress disorder (PTSD) is an important mental health issue in terms
of the number of people affected and the morbidity and functional impairment associated
with the disorder. The purpose of this study was to examine the efficacy of all treatments
for PTSD.
PubMed, MEDLINE, PILOTS, and PsycINFO databases were searched for randomized controlled
clinical trials of any treatment for PTSD in adults published between January 1, 1980,
and April 1, 2012, and written in the English language. The following search terms
were used: post-traumatic stress disorders, posttraumatic stress disorder, PTSD, combat
disorders, and stress disorders, post-traumatic.
Articles selected were those in which all subjects were adults with a diagnosis of
PTSD based on DSM criteria and a valid PTSD symptom measure was reported. Other study
characteristics were systematically collected. The sample consisted of 137 treatment
comparisons drawn from 112 studies.
Effective psychotherapies included cognitive therapy, exposure therapy, and eye movement
desensitization and reprocessing (g = 1.63, 1.08, and 1.01, respectively). Effective
pharmacotherapies included paroxetine, sertraline, fluoxetine, risperidone, topiramate,
and venlafaxine (g = 0.74, 0.41, 0.43, 0.41, 1.20, and 0.48, respectively). For both
psychotherapy and medication, studies with more women had larger effects and studies
with more veterans had smaller effects. Psychotherapy studies with wait-list controls
had larger effects than studies with active control comparisons.
Our findings suggest that patients and providers have a variety of options for choosing
an effective treatment for PTSD. Substantial differences in study design and study
participant characteristics make identification of a single best treatment difficult.
Not all medications or psychotherapies are effective.
© Copyright 2013 Physicians Postgraduate Press, Inc.