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Psychological treatment of post-traumatic stress disorder (PTSD)

  1. Jonathan Bisson1,*,
  2. Martin Andrew2

Editorial Group: Cochrane Depression, Anxiety and Neurosis Group

Published Online: 21 JAN 2009

Assessed as up-to-date: 22 MAY 2007

DOI: 10.1002/14651858.CD003388.pub3

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How to Cite

Bisson J, Andrew M. Psychological treatment of post-traumatic stress disorder (PTSD). Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD003388. DOI: 10.1002/14651858.CD003388.pub3.

Author Information

  1. 1

    Cardiff University, Department of Psychological Medicine, Cardiff, UK

  2. 2

    East Glamorgan Hospital, General Adult Psychiatry, Nr Pontypridd, Mid Glamorgan, UK

*Jonathan Bisson, Department of Psychological Medicine, Cardiff University, Monmouth House, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK. bissonji@cardiff.ac.uk. jon.bisson@btinternet.com.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 21 JAN 2009

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[Figure 1]
Figure 1. Funnel plot shows that the smaller studies may tend to report larger differences between TFCBT and Waitlist/Usual Care and suggests an absence of studies demonstrating no difference or a difference in favour of Waitlist/Usual care.
[Figure 2]
Figure 2. Funnel plot shows that the larger studies demonstrate smaller differences between TFCBT and Waitlist./Usual Care and suggests an absence of smaller studies demonstrating no difference or a difference in favour of Waitlist/Usual care.
[Analysis 1.1]
Analysis 1.1. Comparison 1 Trauma Focused CBT/ Exposure Therapy vs Waitlist/Usual Care, Outcome 1 Severity of PTSD symptoms.
[Analysis 1.2]
Analysis 1.2. Comparison 1 Trauma Focused CBT/ Exposure Therapy vs Waitlist/Usual Care, Outcome 2 Depression.
[Analysis 1.3]
Analysis 1.3. Comparison 1 Trauma Focused CBT/ Exposure Therapy vs Waitlist/Usual Care, Outcome 3 Anxiety.
[Analysis 1.4]
Analysis 1.4. Comparison 1 Trauma Focused CBT/ Exposure Therapy vs Waitlist/Usual Care, Outcome 4 Leaving the study early due to any reason.
[Analysis 1.5]
Analysis 1.5. Comparison 1 Trauma Focused CBT/ Exposure Therapy vs Waitlist/Usual Care, Outcome 5 PTSD diagnosis after treatment.
[Analysis 2.1]
Analysis 2.1. Comparison 2 Stress Management Therapy vs Waitlist/Usual Care, Outcome 1 Severity of PTSD symptoms - Clinician.
[Analysis 2.2]
Analysis 2.2. Comparison 2 Stress Management Therapy vs Waitlist/Usual Care, Outcome 2 Severity of PTSD symptoms - Self-report.
[Analysis 2.3]
Analysis 2.3. Comparison 2 Stress Management Therapy vs Waitlist/Usual Care, Outcome 3 Depression.
[Analysis 2.4]
Analysis 2.4. Comparison 2 Stress Management Therapy vs Waitlist/Usual Care, Outcome 4 Anxiety.
[Analysis 2.5]
Analysis 2.5. Comparison 2 Stress Management Therapy vs Waitlist/Usual Care, Outcome 5 Leaving the study early due to any reason.
[Analysis 2.6]
Analysis 2.6. Comparison 2 Stress Management Therapy vs Waitlist/Usual Care, Outcome 6 PTSD diagnosis after treatment.
[Analysis 3.1]
Analysis 3.1. Comparison 3 Other Therapies vs Waitlist/Usual Care, Outcome 1 Severity of PTSD symptoms - clinician.
[Analysis 3.2]
Analysis 3.2. Comparison 3 Other Therapies vs Waitlist/Usual Care, Outcome 2 Severity of PTSD symptoms - self report.
[Analysis 3.3]
Analysis 3.3. Comparison 3 Other Therapies vs Waitlist/Usual Care, Outcome 3 Depression.
[Analysis 3.4]
Analysis 3.4. Comparison 3 Other Therapies vs Waitlist/Usual Care, Outcome 4 Anxiety - Self report.
[Analysis 3.5]
Analysis 3.5. Comparison 3 Other Therapies vs Waitlist/Usual Care, Outcome 5 Leaving the study early due to any reason.
[Analysis 3.6]
Analysis 3.6. Comparison 3 Other Therapies vs Waitlist/Usual Care, Outcome 6 PTSD diagnosis after treatment.
[Analysis 4.1]
Analysis 4.1. Comparison 4 Group CBT vs Waitlist/Usual Care, Outcome 1 Severity of PTSD symptoms - clinician.
[Analysis 4.2]
Analysis 4.2. Comparison 4 Group CBT vs Waitlist/Usual Care, Outcome 2 Severity of PTSD symptoms - self-report.
[Analysis 4.3]
Analysis 4.3. Comparison 4 Group CBT vs Waitlist/Usual Care, Outcome 3 Leaving the study early due to any reason.
[Analysis 4.4]
Analysis 4.4. Comparison 4 Group CBT vs Waitlist/Usual Care, Outcome 4 PTSD diagnosis after treatment.
[Analysis 5.1]
Analysis 5.1. Comparison 5 Trauma Focused CBT/ Exposure Therapy vs Stress Management Therapy, Outcome 1 Severity of PTSD Symptoms - clinician.
[Analysis 5.2]
Analysis 5.2. Comparison 5 Trauma Focused CBT/ Exposure Therapy vs Stress Management Therapy, Outcome 2 Severity of PTSD symptoms - self report.
[Analysis 5.3]
Analysis 5.3. Comparison 5 Trauma Focused CBT/ Exposure Therapy vs Stress Management Therapy, Outcome 3 Severity of PTSD symptoms - clinician - follow-up (2-5 months).
[Analysis 5.4]
Analysis 5.4. Comparison 5 Trauma Focused CBT/ Exposure Therapy vs Stress Management Therapy, Outcome 4 Severity of PTSD symptoms - self report - follow-up (2-5 months).
[Analysis 5.5]
Analysis 5.5. Comparison 5 Trauma Focused CBT/ Exposure Therapy vs Stress Management Therapy, Outcome 5 Depression.
[Analysis 5.6]
Analysis 5.6. Comparison 5 Trauma Focused CBT/ Exposure Therapy vs Stress Management Therapy, Outcome 6 Depression - follow-up (2-5 months).
[Analysis 5.7]
Analysis 5.7. Comparison 5 Trauma Focused CBT/ Exposure Therapy vs Stress Management Therapy, Outcome 7 Anxiety.
[Analysis 5.8]
Analysis 5.8. Comparison 5 Trauma Focused CBT/ Exposure Therapy vs Stress Management Therapy, Outcome 8 Anxiety - Follow-up (2-5 months).
[Analysis 5.9]
Analysis 5.9. Comparison 5 Trauma Focused CBT/ Exposure Therapy vs Stress Management Therapy, Outcome 9 Leaving the study early due to any reason.
[Analysis 5.10]
Analysis 5.10. Comparison 5 Trauma Focused CBT/ Exposure Therapy vs Stress Management Therapy, Outcome 10 PTSD diagnosis after treatment.
[Analysis 6.1]
Analysis 6.1. Comparison 6 Trauma Focused CBT/Exposure Therapy vs Other Therapies (supportive counselling/hypnotherapy/psychodynamic), Outcome 1 Severity of PTSD symptoms - clinician.
[Analysis 6.2]
Analysis 6.2. Comparison 6 Trauma Focused CBT/Exposure Therapy vs Other Therapies (supportive counselling/hypnotherapy/psychodynamic), Outcome 2 Severity of PTSD symptoms - clinician - follow-up (3 months).
[Analysis 6.3]
Analysis 6.3. Comparison 6 Trauma Focused CBT/Exposure Therapy vs Other Therapies (supportive counselling/hypnotherapy/psychodynamic), Outcome 3 Severity of PTSD symptoms - self report.
[Analysis 6.4]
Analysis 6.4. Comparison 6 Trauma Focused CBT/Exposure Therapy vs Other Therapies (supportive counselling/hypnotherapy/psychodynamic), Outcome 4 Severity of PTSD symptoms - self report - follow-up (2-5 months).
[Analysis 6.5]
Analysis 6.5. Comparison 6 Trauma Focused CBT/Exposure Therapy vs Other Therapies (supportive counselling/hypnotherapy/psychodynamic), Outcome 5 Depression - self report.
[Analysis 6.6]
Analysis 6.6. Comparison 6 Trauma Focused CBT/Exposure Therapy vs Other Therapies (supportive counselling/hypnotherapy/psychodynamic), Outcome 6 Anxiety - self report.
[Analysis 6.7]
Analysis 6.7. Comparison 6 Trauma Focused CBT/Exposure Therapy vs Other Therapies (supportive counselling/hypnotherapy/psychodynamic), Outcome 7 Depression - self-report - follow-up (2-5 months).
[Analysis 6.8]
Analysis 6.8. Comparison 6 Trauma Focused CBT/Exposure Therapy vs Other Therapies (supportive counselling/hypnotherapy/psychodynamic), Outcome 8 Anxiety - self-report - follow-up (2-5 months).
[Analysis 6.9]
Analysis 6.9. Comparison 6 Trauma Focused CBT/Exposure Therapy vs Other Therapies (supportive counselling/hypnotherapy/psychodynamic), Outcome 9 PTSD diagnosis after treatment.
[Analysis 6.10]
Analysis 6.10. Comparison 6 Trauma Focused CBT/Exposure Therapy vs Other Therapies (supportive counselling/hypnotherapy/psychodynamic), Outcome 10 Leaving the study early due to any reason.
[Analysis 6.11]
Analysis 6.11. Comparison 6 Trauma Focused CBT/Exposure Therapy vs Other Therapies (supportive counselling/hypnotherapy/psychodynamic), Outcome 11 Severity of PTSD symptoms - clinician - follow-up (6-9 months).
[Analysis 6.12]
Analysis 6.12. Comparison 6 Trauma Focused CBT/Exposure Therapy vs Other Therapies (supportive counselling/hypnotherapy/psychodynamic), Outcome 12 Severity of PTSD symptoms - self-report - follow-up (6-9 months).
[Analysis 6.13]
Analysis 6.13. Comparison 6 Trauma Focused CBT/Exposure Therapy vs Other Therapies (supportive counselling/hypnotherapy/psychodynamic), Outcome 13 Depression - follow-up (6-9 months).
[Analysis 6.14]
Analysis 6.14. Comparison 6 Trauma Focused CBT/Exposure Therapy vs Other Therapies (supportive counselling/hypnotherapy/psychodynamic), Outcome 14 Anxiety - follow-up (6-9 months).
[Analysis 7.1]
Analysis 7.1. Comparison 7 Stress Management Therapy vs Other Therapies, Outcome 1 Severity of PTSD symptoms - Clincian.
[Analysis 7.2]
Analysis 7.2. Comparison 7 Stress Management Therapy vs Other Therapies, Outcome 2 Anxiety - Self-report.
[Analysis 7.3]
Analysis 7.3. Comparison 7 Stress Management Therapy vs Other Therapies, Outcome 3 Depression - Self-report.
[Analysis 7.4]
Analysis 7.4. Comparison 7 Stress Management Therapy vs Other Therapies, Outcome 4 Severity of PTSD symptoms - clinician - follow-up (3 months).
[Analysis 7.5]
Analysis 7.5. Comparison 7 Stress Management Therapy vs Other Therapies, Outcome 5 Anxiety - self-report - follow-up (3 months).
[Analysis 7.6]
Analysis 7.6. Comparison 7 Stress Management Therapy vs Other Therapies, Outcome 6 Depression - self-report - follow-up (3 months).
[Analysis 7.7]
Analysis 7.7. Comparison 7 Stress Management Therapy vs Other Therapies, Outcome 7 PTSD diagnosis after treatment.
[Analysis 7.8]
Analysis 7.8. Comparison 7 Stress Management Therapy vs Other Therapies, Outcome 8 Leaving the study early due to any reason.
[Analysis 8.1]
Analysis 8.1. Comparison 8 Group CBT (trauma focused) vs Group CBT (non-trauma focused), Outcome 1 Severity of PTSD symptoms.
[Analysis 8.2]
Analysis 8.2. Comparison 8 Group CBT (trauma focused) vs Group CBT (non-trauma focused), Outcome 2 Leaving the study early due to any reason.
[Analysis 8.3]
Analysis 8.3. Comparison 8 Group CBT (trauma focused) vs Group CBT (non-trauma focused), Outcome 3 PTSD diagnosis after treatment.
[Analysis 9.1]
Analysis 9.1. Comparison 9 EMDR vs Waitlist/Usual Care, Outcome 1 Severity of PTSD symptoms - Clinician.
[Analysis 9.2]
Analysis 9.2. Comparison 9 EMDR vs Waitlist/Usual Care, Outcome 2 Severity of PTSD symptoms - self report.
[Analysis 9.3]
Analysis 9.3. Comparison 9 EMDR vs Waitlist/Usual Care, Outcome 3 Depression.
[Analysis 9.4]
Analysis 9.4. Comparison 9 EMDR vs Waitlist/Usual Care, Outcome 4 Anxiety.
[Analysis 9.5]
Analysis 9.5. Comparison 9 EMDR vs Waitlist/Usual Care, Outcome 5 Leaving study early due to any reason.
[Analysis 9.6]
Analysis 9.6. Comparison 9 EMDR vs Waitlist/Usual Care, Outcome 6 PTSD diagnosis after treatment.
[Analysis 10.1]
Analysis 10.1. Comparison 10 EMDR vs Trauma Focused CBT, Outcome 1 Severity of PTSD symptoms - clinician.
[Analysis 10.2]
Analysis 10.2. Comparison 10 EMDR vs Trauma Focused CBT, Outcome 2 Severity of PTSD symptoms - clinicain - follow-up (2-5 months).
[Analysis 10.3]
Analysis 10.3. Comparison 10 EMDR vs Trauma Focused CBT, Outcome 3 Severity of PTSD symptoms - self report.
[Analysis 10.4]
Analysis 10.4. Comparison 10 EMDR vs Trauma Focused CBT, Outcome 4 Depression.
[Analysis 10.5]
Analysis 10.5. Comparison 10 EMDR vs Trauma Focused CBT, Outcome 5 Depression - follow-up (2-5 months).
[Analysis 10.6]
Analysis 10.6. Comparison 10 EMDR vs Trauma Focused CBT, Outcome 6 Anxiety.
[Analysis 10.7]
Analysis 10.7. Comparison 10 EMDR vs Trauma Focused CBT, Outcome 7 Anxiety - follow-up (2-5 months).
[Analysis 10.8]
Analysis 10.8. Comparison 10 EMDR vs Trauma Focused CBT, Outcome 8 Leaving study early due to any reason.
[Analysis 10.9]
Analysis 10.9. Comparison 10 EMDR vs Trauma Focused CBT, Outcome 9 PTSD diagnosis after treatment.
[Analysis 10.10]
Analysis 10.10. Comparison 10 EMDR vs Trauma Focused CBT, Outcome 10 Severity of PTSD symptoms - self-report - follow-up (2-5 months).
[Analysis 11.1]
Analysis 11.1. Comparison 11 EMDR vs Stress Management Therapy, Outcome 1 Severity of PTSD symptoms - clinician.
[Analysis 11.2]
Analysis 11.2. Comparison 11 EMDR vs Stress Management Therapy, Outcome 2 Severity of PTSD symptoms - clinician - follow-up (2-5 months).
[Analysis 11.3]
Analysis 11.3. Comparison 11 EMDR vs Stress Management Therapy, Outcome 3 Severity of PTSD symptoms - self report.
[Analysis 11.4]
Analysis 11.4. Comparison 11 EMDR vs Stress Management Therapy, Outcome 4 Depression.
[Analysis 11.5]
Analysis 11.5. Comparison 11 EMDR vs Stress Management Therapy, Outcome 5 Depression - follow-up (2-5 months).
[Analysis 11.6]
Analysis 11.6. Comparison 11 EMDR vs Stress Management Therapy, Outcome 6 Anxiety.
[Analysis 11.7]
Analysis 11.7. Comparison 11 EMDR vs Stress Management Therapy, Outcome 7 Anxiety - follow-up (2-5 months).
[Analysis 11.8]
Analysis 11.8. Comparison 11 EMDR vs Stress Management Therapy, Outcome 8 Leaving the study early due to any reason.
[Analysis 11.9]
Analysis 11.9. Comparison 11 EMDR vs Stress Management Therapy, Outcome 9 PTSD diagnosis after treatment.
[Analysis 11.10]
Analysis 11.10. Comparison 11 EMDR vs Stress Management Therapy, Outcome 10 Severity of PTSD symptoms - self-report - follow-up (2-5 months).
[Analysis 12.1]
Analysis 12.1. Comparison 12 EMDR vs Other Therapies, Outcome 1 Severity of PTSD symptoms - self report.
[Analysis 12.2]
Analysis 12.2. Comparison 12 EMDR vs Other Therapies, Outcome 2 Depression.
[Analysis 12.3]
Analysis 12.3. Comparison 12 EMDR vs Other Therapies, Outcome 3 Anxiety.
[Analysis 12.4]
Analysis 12.4. Comparison 12 EMDR vs Other Therapies, Outcome 4 Leaving study early due to any reason.
[Analysis 12.5]
Analysis 12.5. Comparison 12 EMDR vs Other Therapies, Outcome 5 PTSD diagnosis after treatment.
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