247737 Differential Efficacy of Psychological and Pharmacological Interventions for PTSD: A Meta-Analytic Review

Monday, October 31, 2011

Stephen Messer, MA, PhD , Center for Psychological Studies, Nova Southeastern University, Fort Lauderdale, FL
Posttraumatic stress disorder (PTSD) is estimated to affect 89% of individuals in the population at some point in their lives. PTSD is associated with high rates of comorbidity. PTSD constitutes a major public health morbidity and mortality burden, highlighting the importance of prevention and intervention efforts. Treatment guidelines for PTSD include expert consensus reviews of the literature and quantitative reviews (i.e., meta-analyses). To a significant, but not overwhelming degree, recommendations are complementary across best-practice and meta-analytic formats. However, agreement across methodologies is not perfect. The current study reviews the extant literature on randomized controlled trials comparing the consensus best pharmacotherapy [Selective Serotonin Reuptake Inhibitors or Serotonin/Norepinephrine Reuptake Inhibitors (SSRIs, SNRIs)]with the consensus best psychological therapies (Trauma-focused Cognitive Behavior Therapy). The current meta-analysis follows the rigorous recommendations of meta-analytic methodological experts(e.g., PRISMA) in comparing the relative efficacy of pharmacological and psychological therapies for PTSD in the adult population. Subgroup and meta-regression analyses will examine relations such as baseline severity of PTSD symptoms, gender, comorbidity, depression diagnosis, baseline symptom scores, and attrition with psychological and pharmacologic treatments of PTSD. The comparative effectiveness of pharmacological and psychological interventions has substantial personal and public health implications.

Learning Areas:
Biostatistics, economics
Clinical medicine applied in public health
Other professions or practice related to public health
Provision of health care to the public

Learning Objectives:
1) Demonstrate the relative efficacy of pharmacological vs. psychological interventions for Posttruaumatic Stress Disorder (PTSD, a highly prevalent menta health problem in the general population, exacerbated by military conflicts such as those ongoing in Iraq and Afghanistan (OIF, OEF)

Keywords: Mental Illness, Treatment Efficacy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I have training in experimental psychology, clinical psychology, psychiatric epidemiology, and mental health services research, and have directed research programs in behavioral epidemiology and clinical psychology in both government and academic settings, and currently teach, consult, and conduct research in research methodology and mental health as a faculty member at a large private university.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.