eprintid: 10091571
rev_number: 68
eprint_status: archive
userid: 608
dir: disk0/10/09/15/71
datestamp: 2020-02-27 19:48:45
lastmod: 2021-09-25 23:27:55
status_changed: 2020-02-27 19:48:45
type: article
metadata_visibility: show
creators_name: Mavranezouli, I
creators_name: Megnin-Viggars, O
creators_name: Daly, C
creators_name: Dias, S
creators_name: Welton, NJ
creators_name: Stockton, S
creators_name: Bhutani, G
creators_name: Grey, N
creators_name: Leach, J
creators_name: Greenberg, N
creators_name: Katona, C
creators_name: El-Leithy, S
creators_name: Pilling, S
title: Psychological treatments for post-traumatic stress disorder in adults: a network meta-analysis
ispublished: pub
divisions: UCL
divisions: B02
divisions: C07
divisions: D05
divisions: F66
divisions: D79
keywords: Interventions, network meta-analysis, post-traumatic stress disorder, systematic review
note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
abstract: BACKGROUND: Post-traumatic stress disorder (PTSD) is a potentially chronic and disabling disorder affecting a significant minority of people exposed to trauma. Various psychological treatments have been shown to be effective, but their relative effects are not well established. METHODS: We undertook a systematic review and network meta-analyses of psychological interventions for adults with PTSD. Outcomes included PTSD symptom change scores post-treatment and at 1-4-month follow-up, and remission post-treatment. RESULTS: We included 90 trials, 6560 individuals and 22 interventions. Evidence was of moderate-to-low quality. Eye movement desensitisation and reprocessing (EMDR) [standardised mean difference (SMD) -2.07; 95% credible interval (CrI) -2.70 to -1.44], combined somatic/cognitive therapies (SMD -1.69; 95% CrI -2.66 to -0.73), trauma-focused cognitive behavioural therapy (TF-CBT) (SMD -1.46; 95% CrI -1.87 to -1.05) and self-help with support (SMD -1.46; 95% CrI -2.33 to -0.59) appeared to be most effective at reducing PTSD symptoms post-treatment v. waitlist, followed by non-TF-CBT, TF-CBT combined with a selective serotonin reuptake inhibitor (SSRI), SSRIs, self-help without support and counselling. EMDR and TF-CBT showed sustained effects at 1-4-month follow-up. EMDR, TF-CBT, self-help with support and counselling improved remission rates post-treatment. Results for other interventions were either inconclusive or based on limited evidence. CONCLUSIONS: EMDR and TF-CBT appear to be most effective at reducing symptoms and improving remission rates in adults with PTSD. They are also effective at sustaining symptom improvements beyond treatment endpoint. Further research needs to explore the long-term comparative effectiveness of psychological therapies for adults with PTSD and also the impact of severity and complexity of PTSD on treatment outcomes.
date: 2020-03
date_type: published
official_url: http://doi.org/10.1017/S0033291720000070
oa_status: green
full_text_type: other
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1758163
doi: 10.1017/S0033291720000070
pii: S0033291720000070
lyricists_name: Katona, Cornelius
lyricists_name: Mavranezouli, Ifigeneia
lyricists_name: Pilling, Stephen
lyricists_id: KCORN64
lyricists_id: IMAVR34
lyricists_id: SPILL91
actors_name: Waragoda Vitharana, Nimal
actors_id: NWARR44
actors_role: owner
full_text_status: public
publication: Psychological Medicine
volume: 50
number: 4
pagerange: 542-555
event_location: England
issn: 1469-8978
citation:        Mavranezouli, I;    Megnin-Viggars, O;    Daly, C;    Dias, S;    Welton, NJ;    Stockton, S;    Bhutani, G;                         ... Pilling, S; + view all <#>        Mavranezouli, I;  Megnin-Viggars, O;  Daly, C;  Dias, S;  Welton, NJ;  Stockton, S;  Bhutani, G;  Grey, N;  Leach, J;  Greenberg, N;  Katona, C;  El-Leithy, S;  Pilling, S;   - view fewer <#>    (2020)    Psychological treatments for post-traumatic stress disorder in adults: a network meta-analysis.                   Psychological Medicine , 50  (4)   pp. 542-555.    10.1017/S0033291720000070 <https://doi.org/10.1017/S0033291720000070>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10091571/1/Katona_PTSD%20adult%20NMA%20manuscript%20R1%20CLEAN.pdf
document_url: https://discovery.ucl.ac.uk/id/eprint/10091571/7/Katona_adult%20NMA%20supplement%20R1%20CLEAN.pdf
document_url: https://discovery.ucl.ac.uk/id/eprint/10091571/19/Katona_PTSD%20adult%20NMA%20Figure%201%20flow%20chart.pdf