Preventing and treating PTSD and related conditions in adults: A research agenda

Abstract

The prevalence of traumatic events in both civilian and military populations and the emotional, financial, physical, and psychosocial burdens of PTSD are high. We conducted two rigorous, protocol-based systematic reviews of the published literature assessing the benefits and harms of psychological and pharmacological interventions to prevent or treat symptoms of post-traumatic stress disorder (PTSD) in adults exposed to trauma. We did not find reliable evidence supporting efficacy for most interventions to prevent PTSD. Evidence does support the effectiveness of several psychological and pharmacological interventions to treat patients with PTSD. Although some psychological interventions produced significant decreases in traumatic stress symptoms and related psychopathology, limitations in the study methods precluded definitive guidelines for preventing PTSD in those exposed to trauma. Lack of definitive evidence on interventions to prevent PTSD in adults makes clinical and policy decision making challenging. Several psychological and pharmacological interventions can reduce symptoms of PTSD in adults, but what treatment to select for individual patients remains uncertain. Practical considerations such as access to care may dictate many clinical choices. Numerous interventions warrant additional investigation, especially in comparative trials. Subgroups require more attention to clarify which interventions are efficacious for different patient populations, and research methods must be strengthened.