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Current evidence-based treatment options for PTSD focus on psychotherapy, with a small selection of pharmacotherapies (Table 2). Patient adherence to medications is a frequent problem, often as a result of side-effects, patient perceptions or limited clinical benefit.
- Joshua C. Morganstein, Gary H. Wynn, James C. West
- 2021
We retrospectively evaluated the effectiveness of trauma-focused psychotherapy (TF-P) versus stabilization and waiting in a civilian cohort of patients with an 11th version of the international classification of disease (ICD-11) diagnosis of complex post-traumatic stress disorder (CPTSD).
Apr 29, 2024 · The most effective treatments for ICD-11–defined complex posttraumatic stress disorder (CPTSD) remain unknown. Further research is needed to determine whether such treatments for CPTSD are the same...
Sep 15, 2024 · Mainstay trauma-focused cognitive-behavioral therapies (CBTs) for posttraumatic stress disorder (PTSD), such as prolonged exposure and cognitive processing therapy, are effective, but dropout rates can be high (e.g., 45%–55% in the largest PTSD trial conducted to date, in the U.S. Department of Veterans Affairs system [1]) and clinical ...
- Selection of Studies
- Data Extraction and Management
- Dichotomous Outcomes
- Continuous Outcomes
- Unit of Analysis Issues
- Meta-Analysis
- Trial Sequential Analysis
- Subgroup Analysis
- Sensitivity Analysis
- “Summary of Findings” Table
Two authors (SJ and SS) will independently screen titles and abstracts. We will retrieve all relevant full-text study reports/publications, and two review authors (SJ and SS) will independently screen the full text and identify and record reasons for exclusion of the ineligible studies. We will resolve any disagreement through discussion, or if req...
Two authors (SJ and SS) will independently extract data from included trials. Disagreements will be resolved by discussion with a third author (JCJ). We will assess duplicate publications and companion papers of a trial together to evaluate all available data simultaneously (maximize data extraction, correct bias assessment). We will contact the tr...
We will calculate risk ratios (RRs) with 95% confidence interval (CI) for dichotomous outcomes, as well as the Trial Sequential Analysis-adjusted CIs (see below).
We will calculate the mean differences (MDs) and consider calculating the standardized mean difference (SMD) with 95% CI for continuous outcomes. We will also calculate trial sequential analysis-adjusted CIs (see below).
We will only include randomized clinical trials. For trials using crossover design, only data from the first period will be included [83, 92]. There will therefore not be any unit of analysis issues. We will not include cluster randomized trials.
We will undertake the meta-analysis according to the recommendations stated in the Cochrane Handbook for Systematic Reviews of Interventions , Keus et al. , and the eight-step assessment suggested by Jakobsen et al. . We will use the statistical software Stata version 16 to analyze data. We will assess our intervention effects with both random-eff...
Traditional meta-analysis runs the risk of random errors due to sparse data and repetitive testing of accumulating data when updating reviews. We wish to control the risks of type I errors and type II errors. We will therefore perform Trial Sequential Analysis on the outcomes, in order to calculate the required information size (that is, the number...
We will perform the following subgroup analyses when analyzing the primary outcomes (quality of life, serious adverse events, and symptom severity). 1. 1. High risk of bias trials compared to low risk of bias trials 2. 2. Types of psychiatric disorders 3. 3. Types of psychotherapy comparisons 4. 4. Trials above and below the mean difference in inte...
To assess the potential impact of the missing data for dichotomous outcomes, we will perform the two following sensitivity analyses on both the primary and secondary outcomes. 1. “Best-worst-case” scenario: We will assume that all participants lost to follow-up in the short-term experimental group had no serious adverse event, had no suicides, had ...
We will create a summary of findings table using each of the prespecified outcomes (quality of life, serious adverse events, symptom severity, suicide and suicide attempts, self-harm, and level of functioning) We will use the five GRADE considerations (bias risk of the trials, consistency of effect, imprecision, indirectness, and publication bias) ...
- Sophie Juul, Sophie Juul, Stig Poulsen, Susanne Lunn, Per Sørensen, Janus Christian Jakobsen, Sebast...
- 2019
Sep 12, 2019 · New research supports trying certain types of psychotherapy first, followed by medication if needed, or starting off with a combination of both. Expert recommendations for treating post-traumatic stress disorder (PTSD) differ.
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One potential future direction is medication-enhanced psychotherapy for PTSD. Medication could potentially strengthen learning and memory, inhibit fear, and facilitate therapeutic engagement (Dunlop et al., 2012 ).
