Structured Abstract

Contents

• Key Messages
• Preface
• Acknowledgments
• Evidence Summary
  • Introduction
  • Results/Key Findings
  • Discussion/Findings in Context: What Does the Review Add to What Is Already Known?
  • Key Limitations and Research Gaps
  • Important Studies Underway
• Introduction
  • Background
  • Scope and Key Questions
  • Organization of This Report
• Methods
  • Topic Refinement and Review Protocol
  • Literature Search Strategy
  • Study Selection
  • Data Extraction
  • Quality (Risk of Bias) Assessment of Individual Studies
  • Data Synthesis
  • Strength of the Body of Evidence
  • Applicability
  • Peer Review and Public Commentary
• Results
  • Results of Literature Searches
  • KQ 1. Efficacy and Comparative Effectiveness of Different Psychological Treatments
  • KQ 1a. Variability in Efficacy or Comparative Effectiveness of Psychological Interventions by Patient Characteristics or Type of Trauma
  • KQ 2. Efficacy and Comparative Effectiveness of Different Pharmacological Treatments
  • KQ 2a. Variability in Efficacy or Comparative Effectiveness of Pharmacological Interventions by Patient Characteristics or Type of Trauma
  • KQ 3. Psychotherapy Versus Pharmacotherapy for Adults With PTSD
  • KQ 3a. Variability in Comparative Effectiveness of Psychological Versus Pharmacological Interventions by Patient Characteristics or Type of Trauma
  • KQ 4. Adverse Effects of Treatments for PTSD
  • Contextual Question (CQ) 1a. Components of Effective Psychological Treatments
  • CQ 1b. Degree of Fidelity of Psychological Interventions Effective in Trial Settings When Implemented in Clinical Practice Settings
• Discussion
  • Key Findings and Strength of Evidence
  • Implications for Clinical and Policy Decisionmaking
  • Limitations of the Comparative Effectiveness Review Process
  • Limitations of the Evidence Base
  • Research Gaps
  • Conclusions
• Appendix A. Intervention Descriptions
• Appendix B. Outcome Measures and Instruments
• Appendix C. Search Strategy
• Appendix D. Excluded Studies
• Appendix E. Risk of Bias Assessment
• Appendix F. Study Characteristics and Findings
• Appendix G. Documentation of Trials Rated High Risk of Bias
• Appendix H. Meta-Analysis Forest Plots
• Appendix I. Strength of Evidence
• Appendix J. Expert Guidance and Review
• Appendix K. PCORI Checklist
• Report References

Suggested citation:

Hoffman V, Middleton JC, Feltner C, Gaynes BN, Weber RP, Bann C, Viswanathan M, Lohr KN, Baker C, Green J. Psychological and Pharmacological Treatments for Adults With Posttraumatic Stress Disorder: A Systematic Review Update. Comparative Effectiveness Review No. 207. (Prepared by the RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center under Contract No. 290-2015-00011-I for AHRQ and PCORI.) AHRQ Publication No. 18-EHC011-EF. PCORI Publication No. 2018-SR-01. Rockville, MD: Agency for Healthcare Research and Quality; May 2018. Posted final reports are located on the Effective Health Care Program search page. DOI: https://doi.org/10.23970/AHRQEPCCER207.

This report is based on research conducted by the RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2015-00011-I). The Patient-Centered Outcomes Research Institute (PCORI) funded the report (PCORI Publication No. 2018-SR-01). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ or PCORI. Therefore, no statement in this report should be construed as an official position of PCORI, AHRQ, or of the U.S. Department of Health and Human Services.

None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report.

The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.

This report is made available to the public under the terms of a licensing agreement between the author and AHRQ. This report may be used and reprinted without permission except those copyrighted materials that are clearly noted in the report. Further reproduction of those copyrighted materials is prohibited without the express permission of copyright holders.

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This report may periodically be assessed for the currency of conclusions. If an assessment is done, the resulting surveillance report describing the methodology and findings will be found on the Effective Health Care Program Web site at: www.effectivehealthcare.ahrq.gov. Search on the title of the report.

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