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Psychological interventions for posttraumatic stress disorder involving primary care physicians: systematic review
Rebekka Gehringer1, Antje Freytag2, Markus Krause2
1Institute of General Practice and Family Medicine, Jena University Hospital, Friedrich-Schiller-University, Bachstr. 18, 07743, Jena, Germany. rebekka.gehringer@med.uni-jena.de.
Background:
Evidence-based psychological interventions for posttraumatic stress disorder (PTSD) are available in specialized settings, but adequate care in primary care is often lacking. The aim of this systematic review was to determine the effectiveness of psychological interventions for PTSD involving primary care physicians (PCPs) and to characterize these interventions as well as their providers.
Method:
A systematic review and meta-analyses of randomized controlled trials (RCTs). Primary outcome were symptoms of PTSD.
Results:
Four RCTs with a total of 774 patients suffering from PTSD symptoms were included, all applying cognitive behavioural based interventions. Three studies with psychological interventions being conducted by case managers were pooled in a meta-analysis. Interventions were not effective in the short term (0-6 months; SMD, - 0.1; 95% CI, - 0.24-0.04; I2 = 0%). Only two studies contributed to the meta-analysis for long term (12-18 months) outcomes yielding a small effect (SMD, - 0.23; 95% CI, - 0.38- -0.08; I2 = 0%).
Conclusions:
Psychological interventions for PTSD in primary care settings may be effective in the long term but number and quality of included studies was limited so the results should be interpreted with caution.
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