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Psychological treatments for chronic post-traumatic stress disorder

Systematic review and meta-analysis

Department of Psychological Medicine, Cardiff University

ANKE EHLERS

Institute Institute of Psychiatry, King’s College London

ROSA MATTHEWS and STEPHEN PILLING

National Collaborating Centre for Mental Health, London

DAVID RICHARDS

Department of Mental Health, University of York

STUART TURNER

University College London, London, UK

Correspondence: Dr Jonathan Bisson, Department of Psychological Medicine, Monmouth House, University Hospital of Wales, Heath Park, Cardiff CF14 4XN, UK. Email: bissonji{at}cf.ac.uk

Declaration of interest None.

*Studies that were part of the meta-analysis.

Background The relative efficacy of different psychological treatments for chronic post-traumatic stress disorder (PTSD) is unclear.

Aims To determine the efficacy of specific psychological treatments for chronic PTSD.

Method In a systematic review of randomised controlled trials, eligible studies were assessed against methodological quality criteria and data were extracted and analysed.

Results Thirty-eight randomised controlled trials were included in the meta-analysis. Trauma-focused cognitive–behavioural therapy (TFCBT), eye movement desensitisation and reprocessing (EMDR), stress management and group cognitive–behavioural therapy improved PTSD symptoms more than waiting-list or usual care. There was inconclusive evidence regarding other therapies. There was no evidence of a difference in efficacy between TFCBT and EMDR but there was some evidence that TFCBT and EMDR were superior to stress management and other therapies, and that stress management was superior to other therapies.

Conclusions The first-line psychological treatment for PTSD should be trauma-focused (TFCBT or EMDR).

This article has been cited by other articles:

				G. H Seidler and F. E Wagner Review: Trauma-focused psychological treatments improve post-traumatic stress disorder symptoms Evid. Based Ment. Health, November 1, 2007; 10(4): 117 - 117. [Full Text] [PDF]

				Reviews of Note Journal Watch Psychiatry, June 18, 2007; 2007(618): 1 - 1. [Full Text]

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