Preventing and treating PTSD and related conditions in adults A research agenda

By Catherine A Forneris, Gerald Gartlehner, Daniel E Jonas, Kathleen Lohr

The prevalence of traumatic events in both civilian and military populations and the emotional, financial, physical, and psychosocial burdens of PTSD are high. We conducted two rigorous, protocol-based systematic reviews of the published literature assessing the benefits and harms of psychological and pharmacological interventions to prevent or treat symptoms of post-traumatic stress disorder (PTSD) in adults exposed to trauma. We did not find reliable evidence supporting efficacy for most interventions to prevent PTSD. Evidence does support the effectiveness of several psychological and pharmacological interventions to treat patients with PTSD. Although some psychological interventions produced significant decreases in traumatic stress symptoms and related psychopathology, limitations in the study methods precluded definitive guidelines for preventing PTSD in those exposed to trauma. Lack of definitive evidence on interventions to prevent PTSD in adults makes clinical and policy decision making challenging. Several psychological and pharmacological interventions can reduce symptoms of PTSD in adults, but what treatment to select for individual patients remains uncertain. Practical considerations such as access to care may dictate many clinical choices. Numerous interventions warrant additional investigation, especially in comparative trials. Subgroups require more attention to clarify which interventions are efficacious for different patient populations, and research methods must be strengthened.

Bibliography

Forneris, C. A., Gartlehner, G., Jonas, D. E., & Lohr, K. (2013). Preventing and treating PTSD and related conditions in adults: A research agenda. (RTI Press Publication No. RB-0005-1309). Research Triangle Park, NC: RTI Press. DOI: 10.3768/rtipress.2013.rb.0005.1309

© 2018 RTI International. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Authors

Catherine A FornerisCatherine A. Forneris, PhD, ABPP, is a professor and licensed psychologist in the Department of Psychiatry, School of Medicine, of the University or North Carolina at Chapel Hill.

Gerald GartlehnerGerald Gartlehner, MD, MPH, a senior health analyst at RTI International, serves as the associate director of the RTI-UNC Evidence-Based Practice Center (EPC) at RTI International; he is also the founding director of the Department for Evidence-Based Medicine and Clinical Epidemiology at the Danube University, Krems, Austria and directs the Austrian Cochrane Collaboration Branch there.

Daniel E JonasDaniel E. Jonas, MD, MPH, is the co-director of the RTI-UNC EPC at the Cecil G. Sheps Center for Health Services Research and assistant professor, Department of Medicine, at UNC-Chapel Hill.

Kathleen LohrKathleen N. Lohr, PhD, is a Distinguished Fellow at RTI International. Her research has involved comparative effectiveness and evidence- based practice, measurement of health status and quality of life, quality of care assessment, clinical practice guidelines, and related health policy issues.

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