A Cochrane review [Abstract] 1 included 21 RCTs with a total of 2721 participants with post-traumatic stress disorder (PTSD). The trials included motor vehicle accident victims or patients who had experienced major physical trauma, women who had experienced a traumatic birth or emergency Caesarean section and caregivers and parents following the news that their child had cancer or was admitted to intensive care.
Multiple session early psychological interventions may be more effective than usual care in reducing PTSD diagnosis at three to six months' follow-up (RR 0.62, 95% CI 0.41 to 0.93; studies = 5; participants = 758, low-certainty evidence). However, there was no statistically significant difference post-treatment (RR 1.06, 95% CI 0.85 to 1.32; studies = 5; participants = 556; very low-certainty evidence) or at seven to 12 months (RR 0.94, 95% CI 0.20 to 4.49; studies = 1; participants = 132; very low-certainty evidence). At the primary endpoint of three to six months, low-certainty evidence indicated no statistical difference between groups in reducing severity of PTSD (SMD -0.10, 95% CI -0.22 to 0.02; studies = 15; participants = 1921), depression (SMD -0.04, 95% CI -0.19 to 0.10; studies = 7; participants = 1009) or anxiety symptoms (SMD -0.05, 95% CI -0.19 to 0.10; studies = 6; participants = 945).
Comment: The quality of evidence is downgraded by study quality (inadequate allocation concealment) and inconsistency (heterogeneity in populations and interventions).
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