Characteristics of included studies [ordered by study ID]
Cohen 2007
|
| Methods | RCT |
|
| | Participants | Setting: Unclear
Recruitment strategy: Consecutively referred
Country: USA
N: Number randomised 24 (12 to each treatment)
Exclusion criteria: non-English speaking; schizophrenia or other active psychotic disorder; mental retardation or pervasive developmental disorder (all due to the requirement to receive TF-CBT, a cognitive-oriented psychotherapy); or taking current psychotropic medications. Current substance dependence.
Primary diagnosis? PTSD
How was PTSD measured? At least five PTSD symptoms on the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version [K-SADS-PL] with at least one symptom in each of the three PTSD clusters and clinically significant impairment
Index trauma? contact sexual abuse that was confirmed by Child Protective Services
Time since incident episode: Total only provided - mean months since most recent abuse 22.9(SD 35.6)
Previous treatment for PTSD: Not stated
Previous treatment for other mental disorders? Not stated
Age Total Range only provided 5 x 10-11yrs; 10 x 12-14yrs; 7 x 15-17yrs
Sex: 100% Female
Ethnicity: total only - 17 white; 5 African American
Comorbid substance use: Not stated
Suicidality: Not stated
Comorbidity: 68.2% met criteria for comorbid diagnoses (TF-CBT+Sert =72.7%; TF-CBT+Placebo = 63.5%). All but one had MDD; other diagnoses included general anxiety disorder, substance abuse not otherwise specified, oppositional defiant disorder, panic disorder, and anorexia nervosa. |
|
| | Interventions | Comparison Group 1
Type: Pharmacotherapy and Psychotherapy combined
Pharmacotherapy: Sertraline: started at 25mg and titrated to 50mg - 200mg day as clinically indicated
Length of pharmacotherapy: 12 weeks
Other treatments being used: None
Psychotherapy: Trauma focused CBT - (TF-CBT)
Individual/group: Individual
Manualised: There are two published books and a web-based learning course
Delivered by: One of two randomly assigned clinicians who were licensed masters level social workers
Length of sessions: Unclear.
Number of sessions: 12
Length of intervention: 12 weeks
How many sessions actually delivered: Unclear
Was it intended as intervention or control: As intervention condition with Sertraline/placebo control condition
Comparison Group 2
Type: Psychotherapy and placebo
Pharmacotherapy: Placebo pill
Psychotherapy: As above |
|
| | Outcomes | PTSD symptoms (K-SADS-PL and CPSS)
Global impairment (CGAS)
Depression (MQF)
Anxiety symptoms (SCARED)
Suicidal ideation
Child-abuse related attributions and perceptions (The Childrens Attributions and Perceptions Scale)
Childrens' behaviour and symptoms (CBCL)
Parental depression (BDI)
Parental emotional distress (The Parent's Emotional Reaction Questionnaire)
Parental support (the Parental Support Questionnaire)
Sertraline side effects (SEF-CA) |
|
| | Notes | |
|
| | Risk of bias |
| | Item | Authors' judgement | Description |
| | Adequate sequence generation? | Yes | ..."randomised according to a computerized random number sequence" (p. 814) |
| | Allocation concealment? | Unclear | No statement |
| Blinding?
Outcome assessor | Yes | ..."double-blind procedure whereby no one directly involved in the study (i.e., parents, children, independent evaluator, therapists, or child and adolescent psychiatrist) knew which condition the children were assigned to throughout the course of treatment" (p. 814) |
| Incomplete outcome data addressed?
All outcomes | Unclear | Number dropped out: 1 TF-CBT + Sertraline; 1 TF-CBT + Placebo
ITT analysis not undertaken, unclear description of reason for drop-outs |
| | Free of selective reporting? | No | All a-prior outcomes described in methods were reported on but not in a usable format for meta-analysis; e.g. total PTSD symptoms were not reported on for the sertraline and placebo groups separately |
| | Free of other bias? | No | Low recruitment rate; large number refused due to medication concerns |
|
|
Otto 2003
|
| Methods | RCT |
|
| | Participants | Setting: Unclear
Recruitment strategy: Unclear
Country: USA (but participants are Cambodian refugees)
N: Randomised 10
Exclusion criteria: Not stated
Primary diagnosis? Current PTSD, failure to respond to clonazepam
How was PTSD measured? Structured interview for PTSD ? DSM-IV
Severity:
CAPS re-experiencing:
Intervention: 21.4 (6.3); Control: 15.2 (6.2)
CAPS avoidance/numbing
Intervention: 24.4(12.1); Control:21.4(14.7)
CAPS hyperarousal:
Intervention: 18.8(10.1); Control:20.6 (9.8)
Index trauma: Pol Pot regime with exposure to starvation, overwork, illness, or execution. In addition many survivors were subjected to the constant threat of death, torture, severe physical deprivation, physical and sexual violence, and physical displacement
Time since incident episode: Total only provided : Approx 21-25 years ago
Previous treatment for PTSD: Total only provided: Pharmacotherapy: Clonazapam, SSRI (not Sertraline)
Previous treatment for other mental disorders? Not stated
Age: Total only provided 47.2 years
Sex: 100% female
Ethnicity: All Cambodian
Comorbid substance use: Not stated
Suicidality: Not stated
Comorbid anxiety:
HSCL-90 anxiety:
Intervention: 29.2 (8.5);Control: 31.4 (6.2)
Anxiety sensitivity index (ASI)
Intervention:38.8 (11.0);Control 37.6 (15.2)
ASI-Khmer items:
Intervention: 37.6 (15.2);Control: 51.4 (7.8)
Comorbid depression
HSCL-90 depression:
Intervention: 34.4 (7.6);Control: 38.2 (9.2)
HSCL-90 somatisation:
Intervention: 36.2 (9.4);Control: 26.2 (6.1) |
|
| | Interventions | COMPARISON GROUP 1
Type: Pharmacotherapy alone
Pharmacotherapy: Sertraline: 25mg/d for Week 1; 50mg/d for Week 2; with titration up by 50mg/d to a maximum of 200 mg/d.
Length of pharmacotherapy: Unclear
Other treatments being used: Unclear; however, ‘clonazepam treatment was held constant 0.5-1mg, BID; adjunctive treatment with benzodiazepam also use.
COMPARISON GROUP 2
Type: Pharmacotherapy and Psychotherapy combined
Pharmacotherapy: As above
Psychotherapy: CBT - culture specific
Individual/group: Group
Manualised: Unclear
Delivered by: Unclear
Length of sessions: Unclear.
Number of sessions: 10
Length of intervention: Unclear
How many sessions actually delivered: Unclear
Was it intended as intervention or control: As intervention added on to Sertraline (control condition) |
|
| | Outcomes | PTSD symptoms (CAPS re-experiencing, avoidance/numbing and hyperarousal symptoms)
Measures of comorbid anxiety (HSCL-90 anxiety, ASI, ASI-Khmer)
Measures of comorbid depression (HSCL-90 depression; HSCL-90 somatisation) |
|
| | Notes | |
|
| | Risk of bias |
| | Item | Authors' judgement | Description |
| | Adequate sequence generation? | Unclear | No statement |
| | Allocation concealment? | Unclear | No statement |
| Blinding?
Outcome assessor | Unclear | No statement |
| Incomplete outcome data addressed?
All outcomes | Unclear | No statement |
| | Free of selective reporting? | No | Total PTSD symptom scores not reported by group |
| | Free of other bias? | Unclear | Small trial; some baseline imbalance in symptom severity |
|
|
Rothbaum 2006
|
| Methods | RCT |
|
| | Participants | Setting: Outpatient
Recruitment strategy: Advertisements, referrals from professionals
Country: USA
N = Number randomised = 65 for phase 2
Exclusion criteria: History of psychotic, bipolar disorder; prior failure with Sertraline, medical contraindications to taking sertraline; current administration of psychiatric medication
Primary diagnosis? Primary psychiatric diagnosis of PTSD, duration >=3 months
How was PTSD measured? Structured clinical interview for DSM-IV Severity:
Intervention: Wk 10 Mean (SD) SIP 16.16 (10.64)
Control: Wk 10 Mean (SD) SIP 14.5 (11.65)
Index trauma? The most common index traumas were sexual assault, including childhood sexual abuse (37%); nonsexual assault, including childhood physical abuse (25%); and the death (not combat-related) of another person (22%), usually someone of significance to the participant (i.e., child, parent, sibling, spouse or romantic partner).Another 9% reported being in a motor-vehicle accident as the index trauma.
The remaining traumas coded as other were one case each of the following: combat exposure, house fire, airplane crash, discovering a parent after a nonfatal overdose, and a police officer who felt he came very close to shooting an unarmed suspect.
Time since incident episode: Total only provided (n=43) 8.1 years (11.77SD)
Previous treatment for PTSD: not stated
Previous treatment for other mental disorders? open label treatment with sertraline for 10 weeks as part of protocol (called Phase 1)
Age: Total only provided mean (SD) = 39.3 (10.69)
Sex: Total only provided 35.4% male; 64.6% female
Ethnicity: Total only provided 80% White; 18.5% Afr-Am; 1.5% Other
Comorbidity: 63% had current major depression, dysthymia or both; 52% had one or more anxiety disorder
Comorbid substance use: not stated
Suicidality: not stated
Comorbid anxiety:
STAI-S Mean (SD) Wk 10
Intervention:43.0(13.21); Control:39.2(13.90)
Comorbid depression
BDI Mean (SD) Wk 10
Intervention: 11.2(8.94);Control: 9.5 (7.57) |
|
| | Interventions | COMPARISON GROUP 1
Type: Pharmacotherapy alone
Pharmacotherapy: 10 weeks of open-label Sertraline, 200mg/day or maximum tolerated dose; followed 5 weeks of Ssertraline, started at 25 mg/day increased to 200mg or maximum tolerated dose per day. The average dose was 173.1 mg/day at the beginning of week 10 and 173.5mg/day at week 15.
COMPARISON GROUP 2
Type: Pharmacotherapy and psychotherapy combined
Pharmacotherapy: As above
Psychotherapy: Prolonged exposure (PE) therapy
Individual/group: Individual
Manualised: Yes
Delivered by: Therapists trained in the use of PE
Length of sessions: 90-120 minutes.
Number of sessions: 10
Length of intervention: 5 weeks
How many sessions actually delivered: Unclear; 10 for completers unknown for non-completers.
Was it intended as intervention or control: As intervention added on to sertraline (control condition) |
|
| | Outcomes | Reduction in PTSD symptoms (SIP)
Reduction in comorbid anxiety (STAI)
Reduction in comorbid depression (BDI) |
|
| | Notes | For depression and anxiety scores, the SD has been imputed for each group from the combined SD of the change score. Mean change scores for each group were calculated from endpoint scores in Table 2. |
|
| | Risk of bias |
| | Item | Authors' judgement | Description |
| | Adequate sequence generation? | Unclear | No statement |
| | Allocation concealment? | Unclear | No statement |
| Blinding?
Outcome assessor | Yes | "independent evaluators" p 630; "The independent evaluators were not otherwise involved in participants’ treatment and were kept blind to the treatment condition of those participants who entered Phase II" p 631.
Additional information from the author:
"the only person who was kept blind to treatment condition was the IE, and of course, the IE was only blind to whether the person got PE or not during phase II. The IE was not blind to the fact that the person was on sertraline. We instructed the patient not to discuss therapy with the IE and we took steps to prevent the IE from seeing the patient accompanied by a study therapist (e.g., having IE behind office doors when the patient was in for a therapy visit, taking the "back route" to a therapist's office to avoid the waiting room, changing the IE if the blind was blown, excluding the IE from supervision of study cases)" |
| Incomplete outcome data addressed?
All outcomes | Yes | Drop outs described and ITT analysis undertaken; uneven drop outs across groups (number dropped out: Intervention: 6 Phase 2 ; Control: 1 Phase 2) |
| | Free of selective reporting? | Unclear | Usable data not fully reported |
| | Free of other bias? | No | |
|
|
Simon 2008
|
| Methods | RCT |
|
| | Participants | Setting: Outpatient
Recruitment strategy: Advertisements and clinical referral
Country: USA
N: Intervention: 9; Control: 14
Exclusion criteria: Serious medical illness; pregnant or lactating women; concurrent use of other psychotropic medication; lifetime diagnosis of schizophrenia or psychotic disorder; mental retardation; organic mental disorders or bipolar disorder; OCD exhibited in last six months; eating disorders; cutting or self-injurious behaviour or alcohol or substance abuse disorders within the last 6 months; current primary diagnosis of MDD, dysthymia, social anxiety disorder or GAD; history of hypersensitivity or poor response to paroxetine; Current compensation of legal action related to effects of trauma, those with ongoing relationship with assailant.
Primary diagnosis? PTSD with participants still symptomatic (greater than or equal to 6 on SPRINT and CGI-S greater than or equal to 3) after 8 sessions of prolonged exposure
How was PTSD measured? Mini International Neuropsychiatric Interview (MINI) for DSM-IV
Severity: all participants remained symptomatic after 8 sessions of PE
SPRINT total score:
Intervention: 16.11 ; Control 17.00
CGI-S:
Intervention: 4.11 ; Control 4.00
Index trauma?
Physcial and/or sexual abuse: intervention 89%; control 57%
Exposure to war: intervention 0%; control 14%
Physical accident and/or medical trauma: intervention 11%; control 29%
Time since incident episode: Unclear
Previous treatment for PTSD: 8 sessions of Prolonged Exposure therapy as part of protocol
Previous treatment for other mental disorders? Unclear
Age Intervention mean 47.8; Control mean 44.2
Sex Intervention F=4 (44%) M=5 (56%); Control F=9 (64%) M=5(36%)
Ethnicity Intervention 71% white; Control 78% white
Comorbid substance use: unclear
Suicidality Those with cutting or self-injurious behaviour were excluded but no other detail about baseline suicidality given
Comorbid anxiety/depression
Number with at least 1 mood or anxiety disorder:
Intervention: 8 (89%); Control: 11(79%)
Number with MDD:
Intervention: 3 (33%); Control: 9 (64%) |
|
| | Interventions | COMPARISON GROUP 1
Type: Pharmacotherapy and Psychotherapy combined
Pharmacotherapy: Paroxetine-CR initiated at 12.5mg/day and flexibly titrated based on efficacy and tolerability from 12.5mg/day to a maximum of 62.5mg/day for 10 weeks. Included management by a study psychiatrist during 10-20 minute sessions weekly for first two weeks and then once every two weeks.
Mean dose 45.8 (SD16.5)
Psychotherapy: Prolonged exposure (PE) therapy
Individual/group: Individual
Manualised: Yes
Delivered by: Trained therapists who received certification in PE
Length of sessions: 90-120 minutes
Number of sessions: 5 once every two weeks
Length of intervention: 10 weeks
How many sessions actually delivered: not reported
Was it intended as intervention or control: as intervention added on to PE (control condition)
COMPARISON GROUP 2
Type: Psychotherapy and placebo
Pharmacotherapy: placebo (mean dose 44.8 (SD15.5)
Psychotherapy: As above |
|
| | Outcomes | Level of impairment ( CGI-S)
PTSD symptoms (SPRINT) |
|
| | Notes | |
|
| | Risk of bias |
| | Item | Authors' judgement | Description |
| | Adequate sequence generation? | Unclear | No description except that random assignment was blocked by CGI-S score |
| | Allocation concealment? | Yes | Additional information from author: "Study was double blind with the study staff giving the patient a randomization number that only the research pharmacy supplying the medication knew was placebo or active medication" |
| Blinding?
Outcome assessor | Yes | Additional information from author: "Study was double blind". Paper describes a "rater blind to treatment assignment" pg 401 |
| Incomplete outcome data addressed?
All outcomes | Yes | 5 drop outs; two before starting medication and not included in ITT analysis, 1 additional from medication group due to inpatient admission for suicidal ideation; 2 from placebo group due to dizziness/nausea (1) and noncompliance (1). |
| | Free of selective reporting? | Unclear | No information about outcome measurement planned a-priori. |
| | Free of other bias? | No | small study; some imbalance - more females in placebo group; more participants in placebo group had MDD; more participants in medication group had index trauma of sexual abuse |
|
|
Characteristics of excluded studies [ordered by study ID]
|
| Study | Reason for exclusion |
|---|
| | Abramowitz 2008 | The study treatments are hypnotherapy and zolpidem aimed at the sleep difficulties being suffered by participants with PTSD who are already medicated with an SSRI and receiving psychotherapy |
| | Bouso 2008 | Dose-finding (rather than effectiveness) trial |
| | Brunet 2008 | 'Script driven traumatic imagery' did not meet criteria for psychological therapy for this review |
| | Chan 2008 | Intervention 'collaborative care'; does not meet inclusion criteria |
| | Clark 2008 | Participants not randomised to a combined intervention |
| | Cottraux 2008 | Participants not randomised to a combined intervention |
| | Drozdek 1997 | Medication not controlled and not clear whether groups are randomised |
| | Hinton 2004 | Participants not randomised to a combined intervention |
| | Hinton 2005 | Participants not randomised to a combined intervention |
| | Kessler 2003 | No random assignment to combined treatment (no mention of pharmacotherapy); unlikely that participants have a primary diagnosis of PTSD |
| | Oflaz 2008 | Not an RCT |
| | Osuch 2009 | The pharmacological component of the trial was delivered in combination with repetitive transcranial magnetic stimulation (rTMS) and not a psychological therapy |
| | Resnick 2008 | Participants not randomised to a combined intervention |
| | van der Kolk 2007 | No combined intervention group |
| | Wright 2003 | No random assignment to combined treatment; 90% of participants already on prescribed medication; the intervention targeted major depressive disorder |
| | Zucker 2009 | Biofeedback not an eligible psychological intervention |
|
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Characteristics of ongoing studies [ordered by study ID]
Gamito 2005
|
| Trial name or title | Virtual war PTSD |
| | Methods | 3 armed RCT |
| | Participants | Males with the diagnostic of War PTSD according to DSM-IV-TR who looked for treatment at Hospital Julio de Matos in Lisbon, Portugal. |
| | Interventions | Virtual reality exposure (VRE); Drug treatment; VRE + Drug Treatment. The adequate therapeutic dosage of Sertraline (Zoloft, Pfeizer) will be administrated during 16 weeks to the Drug Treatment groups. VRE groups will use a Head Mounted Device that enables fully immersive experience in the following war virtual scenarios: mine deflagration, mine deflagration + ambush, ambush and assisting casualties and waiting for a rescue helicopter. |
| | Outcomes | CAPS, BDI, STAI, SCL-90, MCM-II for psychometric measures and TAS, DES, PQ, SUDS, heart rate and blood pressure, ECG, EEG and ACTH for physiological measures are the evaluation procedures selected for assessing the results. |
| | Starting date | |
| | Contact information | |
| | Notes | |
|
|
Guay 2007
|
| Trial name or title | Comparative Study of the Efficacy of a Cognitive-Behavioral Therapy for Post-Traumatic Stress Disorder With or Without D-Cycloserine |
| | Methods | RCT |
| | Participants | Either gender, aged 18 to 65, clinical diagnosis of PTSD |
| | Interventions | CBT with and without D-Cycloserine |
| | Outcomes | Primary Outcome Measures: Clinician-administered measures collected at initial assessment, post-treatment and six-months follow-up:
CAPS: PTSD symptoms
SCID: AXIS I disorders
Secondary Outcome Measures: Patient self-report forms collected at initial assessment, post-treatment and six-months follow-up:
BDI: depression symptoms
BAI: anxiety symptoms
WHOQL-Bref: quality of life |
| | Starting date | February 2007 |
| | Contact information | Sarah Jane Parent: sparent.hlhl@ssss.gouv.qc.ca |
| | Notes | Authors will have to consider their inclusion criteria as d-cycloserine |
|
|
Hicks 2009
|
| Trial name or title | Predictors of Treatment Response to Fluoxetine in PTSD Following a Recent History of War Zone Stress Exposure |
| | Methods | Double blind placebo controlled prospective 12 week trial of fluoxetine in veterans already receiving usual psychological treatment |
| | Participants | Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) veterans |
| | Interventions | Double-blind, placebo-controlled prospective 12-week trial of fluoxetine in OEF/OIF campaign veterans. All participants will (also) receive usual psychological treatment by mental health services of the Carl R. Darnall Army Medical Center |
| | Outcomes | PTSD symptom severity and related functional impairment, comorbid depression, anxiety symptoms, and alcohol intake |
| | Starting date | Enrolling from 2009 |
| | Contact information | Paul Hicks, Central Texas Veterans Health Care System, USA |
| | Notes | |
|
|
McAllister 2009
|
| Trial name or title | Venlafaxine and CBT for Psychological Distress After TBI: A Randomized Controlled Trial |
| | Methods | 12 week RCT |
| | Participants | Veterans and service members who have mild to severe TBI and PTSD or MDD |
| | Interventions | Venlafaxine XR (VFN), Cognitive Behavioral Therapy (CBT), and a placebo and psycho-educational control (CTL) |
| | Outcomes | Primary outcomes: PTSD and depression symptoms; secondary aims include comparing response, remission, and relapse rates; determining if treatment is associated with greater improvement in neuropsychological functioning, functional status, and post-concussive symptoms; examining tolerability and cost-effectiveness of VFN and CBT for the treatment of PTSD and MDD; and exploring predictors of treatment response |
| | Starting date | Enrolling in 2009 |
| | Contact information | Thomas W McAllister, Dartmouth Medical School, Dartmouth, New Hampshire, USA |
| | Notes | |
|
|
Pai 2004
|
| Trial name or title | Treating co-morbid PTSD and alcohol dependence |
| | Methods | RCT |
| | Participants | Setting: Community-Outpatient
Recruitment strategy: Newspaper advertisement, Veterans Administration
Country: USA
Exclusion criteria: Current DSM diagnosis of substance dependence other than alcohol, nicotine, cannabis; 2) opiate use in past 30 days; 3) significant risk of violence/ history of serious violent behaviour in past 4 years; 4) report assault as index trauma combined with continuing relation ship with perpetrator; 5) current treatment for psychotropic medications(excl short-term use of benzodiazepines for detoxification); 6 unstable or serious medical illness; 7) current severe psychiatric symptoms; 8) mental retardation or other pervasive developmental disorder; 9) investigational medication in past 30 days; 10) for women, pregnant, nursing or non-use of reliable contraception
Primary diagnosis? PTSD and Alcohol dependence |
| | Interventions | COMPARISON GROUP 1
Type: Pharmacotherapy and Psychotherapy combined
Pharmacotherapy: Naltrexone 50mg/morning for 3 days then 100mg/morning
Length of pharmacotherapy: 24 weeks
Psychotherapy: CBT ? prolonged exposure therapy
Individual/group: Individual
Manualised: Yes
Delivered by: Psychologists and a registered nurse
Number of sessions: 18 - 1/week for 12 weeks, then 1/fortnight for 12 weeks.
Length of intervention: 24 weeks
How many sessions actually delivered: ongoing study
Was it intended as intervention or control: As control condition with Naltrexone/placebo intervention condition
COMPARISON GROUP 2
Type: Psychotherapy and placebo
Pharmacotherapy: Placebo
Length of pharmacotherapy: 24 weeks
Psychotherapy: CBT ? prolonged exposure therapy
Individual/group: Individual
Manualised: Yes
Delivered by: Psychologists and a registered nurse
Number of sessions: 18 - 1/week for 12 weeks, then 1/fortnight for 12 weeks.
Length of intervention: 24 weeks
COMPARISON GROUP 3
Type: Placebo medication alone
Type of pharmacotherapy: Placebo pill |
| | Outcomes | Alcohol consumption ( Days drinking; drinks per drinking day; alcohol craving using Timeline Follow-Back Interview and Penn Alcohol Craving Scale)
PTSD symptoms
(PTSD Symptom Scale, PSS-I) |
| | Starting date | |
| | Contact information | Professor E Foa Director, Director of the Center for the Treatment and Study of Anxiety
University of Pennsylvania
3535 Market Street, 6th Floor
Philadelphia, PA 19104, USA |
| | Notes | |
|
|
Comparison 1. Combined SSRI plus CBT versus SSRI alone (adults)
|
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
|---|
| | 1 PTSD symptom severity (clinician rated) post intervention (final scores SIP) | 1 | 65 | Mean Difference (IV, Fixed, 95% CI) | -4.70 [-10.84, 1.44] |
| | 2 Drop outs | 1 | 65 | Risk Ratio (M-H, Fixed, 95% CI) | 5.47 [0.70, 42.93] |
| | 3 Depression severity (self rated) post intervention (change scores) | 2 | 74 | Std. Mean Difference (IV, Fixed, 95% CI) | -0.40 [-0.86, 0.07] |
| | 4 Anxiety severity (self rated) post intervention (change scores) | 2 | 74 | Std. Mean Difference (IV, Fixed, 95% CI) | -0.39 [-0.85, 0.07] |
|
|
Comparison 2. Combined SSRI plus CBT versus PE alone (adults)
Comparison 3. Combined SSRI plus TFCBT versus TFCBT alone (children/adolescents)
|
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
|---|
| | 1 Drop outs | 1 | 24 | Risk Ratio (M-H, Fixed, 95% CI) | 0.5 [0.05, 4.81] |
| | 2 Functioning CGAS | 1 | 22 | Mean Difference (IV, Fixed, 95% CI) | 7.09 [-1.19, 15.37] |
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