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