Comment: The quality of evidence is downgraded by study limitations (participants were likely to have been aware of whether they received active or inactive intervention and diagnosis/scores were based on self reported measures).
A Cochrane review [Abstract] 1 included 51 studies with a total of 6201 children and adolescents. Participants were exposed to different traumas (sexual abuse in 12 trials, to war or community violence in 10, to physical trauma and natural disaster in 6 each and to interpersonal violence in 3, and life-threatening illness, physical abuse etc.). Various therapies were used (cognitive-behavioural therapy [CBT], family therapy, debriefing, eye movement desensitisation and reprocessing [EMDR], narrative therapy, psychoeducation, and supportive therapy).
The likelihood of being diagnosed with post-traumatic stress disorder (PTSD) was significantly reduced with CBT (3 trials), family therapy or EMDR (1 trial each) compared to those who received no treatment, treatment as usual or were on a waiting list for up to a month following treatment (table T1). PTSD symptoms were also significantly reduced for a month after therapy. These effects of psychological therapies were not apparent over the longer term.There was no difference in effectiveness of CBT compared with EMDR or supportive therapy in reducing diagnosis of PTSD in the short term (table T2). For reduction of PTSD symptoms in the short term, there was a small effect favouring CBT over EMDR, play therapy and supportive therapies.
| Outcomes (short-term) | Relative effect(95% CI) | Risk with control | Risk with intervetnion - All psychotherapies (95% CI) | No of participants(studies), quality of evidence |
|---|---|---|---|---|
| PTSD diagnosis | OR 0.51(0.34 to 0.77) | 367 / 1000 | 228 / 1000(165 to 309) | 874(5), very low evidence |
| PTSD total symptoms | Moderate effect size | Mean total symptoms were 0.42 standard deviations fewer (0.61 fewer to 0.24 fewer) | 2051(15), low evidence |
| Outcome (short-term) | Relative effect(95% CI) | Risk with control - Other therapies | Risk with intervention - CBT | No of participants(studies), quality of evidence |
|---|---|---|---|---|
| PTSD diagnosis | OR 0.74(0.29 to 1.91) | 141 / 1000 | 108 / 1000(45 to 239) | 160(2), very low evidence |
| PTSD total symptoms | Small effect size | Mean total symptoms were 0.24 standard deviations fewer (0.42 fewer to 0.05 fewer) | 466(7), moderate evidence |
Date of latest search: 29 May 2015
Primary/Secondary Keywords