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Integrating fragmented evidence by network meta-analysis: relative effectiveness of psychological interventions for adults with post-traumatic stress disorder

Gerger, H. and Munder, T. and Gemperli, A. and Nüesch, E. and Trelle, S. and Jüni, P. and Barth, J.. (2014) Integrating fragmented evidence by network meta-analysis: relative effectiveness of psychological interventions for adults with post-traumatic stress disorder. Psychological Medicine, 44 (15). pp. 3151-3164.

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Official URL: http://edoc.unibas.ch/39362/

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Abstract

To summarize the available evidence on the effectiveness of psychological interventions for patients with post-traumatic stress disorder (PTSD).; We searched bibliographic databases and reference lists of relevant systematic reviews and meta-analyses for randomized controlled trials that compared specific psychological interventions for adults with PTSD symptoms either head-to-head or against control interventions using non-specific intervention components, or against wait-list control. Two investigators independently extracted the data and assessed trial characteristics.; The analyses included 4190 patients in 66 trials. An initial network meta-analysis showed large effect sizes (ESs) for all specific psychological interventions (ESs between -1.10 and -1.37) and moderate effects of psychological interventions that were used to control for non-specific intervention effects (ESs -0.58 and -0.62). ES differences between various types of specific psychological interventions were absent to small (ES differences between 0.00 and 0.27). Considerable between-trial heterogeneity occurred (τ²= 0.30). Stratified analyses revealed that trials that adhered to DSM-III/IV criteria for PTSD were associated with larger ESs. However, considerable heterogeneity remained. Heterogeneity was reduced in trials with adequate concealment of allocation and in large-sized trials. We found evidence for small-study bias.; Our findings show that patients with a formal diagnosis of PTSD and those with subclinical PTSD symptoms benefit from different psychological interventions. We did not identify any intervention that was consistently superior to other specific psychological interventions. However, the robustness of evidence varies considerably between different psychological interventions for PTSD, with most robust evidence for cognitive behavioral and exposure therapies.
Faculties and Departments:07 Faculty of Psychology > Departement Psychologie > Forschungsbereich Klinische Psychologie und Neurowissenschaften > Klinische Psychologie und Psychotherapie (Gaab)
UniBasel Contributors:Gerger, Heike
Item Type:Article, refereed
Article Subtype:Research Article
ISSN:1469-8978
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:05 Feb 2019 18:09
Deposited On:05 Feb 2019 18:09

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