Project Summary
View Systematic Review Update Report
Posttraumatic stress disorder (PTSD) involves a group of symptoms experienced after exposure to a potentially traumatic event that may include re-experiencing the event; avoiding situations that trigger memories of the event; experiencing increased negative feelings and beliefs; and/or experiencing feelings of hyperarousal such as irritability, agitation, anger, or being on alert. PTSD is associated with significant social, personal, and economic costs. People affected by PTSD have high rates of psychiatric comorbidity; have problems with functioning (e.g., family, work, social); and tend to suffer adverse consequences such as difficulties with educational attainment, work earnings, marriage attainment, and child rearing over the life course. Treatment guidelines typically include guidance about both psychological and pharmacological types of treatments. This systematic review is an update of an earlier report published by the Agency for Healthcare Research and Quality’s Effective Healthcare Program in 2013.
The key questions (KQs) for this systematic review update derive from the original review and have been updated based on stakeholder feedback obtained by PCORI. The key questions are:
- What is the comparative effectiveness of different psychological treatments for adults diagnosed with PTSD?
- How does comparative effectiveness vary by patient characteristics or type of trauma experienced?
- What is the comparative effectiveness of different pharmacological treatments for adults diagnosed with PTSD?
- How does comparative effectiveness vary by patient characteristics or type of trauma experienced?
- What is the comparative effectiveness of different psychological treatments and pharmacological treatments for adults diagnosed with PTSD?
- How does comparative effectiveness vary by patient characteristics or type of trauma experienced?
- What adverse events (AEs) are associated with treatments for adults diagnosed with PTSD? The review also asks a contextual question, which is not systematically reviewed but uses a "best evidence" approach:
- What are the components of effective psychological treatments (e.g., frequency or intensity of therapy, and/or aspects of the therapeutic modality)?; and
- For psychological interventions that are effective in trial settings, what is the degree of fidelity when implemented in clinical practice settings?