Psychological interventions for posttraumatic stress disorder involving primary care physicians: systematic review and M
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RESEARCH ARTICLE
Open Access
Psychological interventions for posttraumatic stress disorder involving primary care physicians: systematic review and Meta-analysis of randomized controlled trials Rebekka Gehringer1*† , Antje Freytag1†, Markus Krause1, Peter Schlattmann2, Konrad Schmidt1, Sven Schulz1, Sophie Jana Zezulka1, Florian Wolf1, Jonas Grininger3, Mathias Berger4, Horst Christian Vollmar1,5† and Jochen Gensichen3†
Abstract Background: Evidence-based psychological interventions for posttraumatic stress disorder (PTSD) are available in specialized settings, but adequate care in primary care is often lacking. The aim of this systematic review was to determine the effectiveness of psychological interventions for PTSD involving primary care physicians (PCPs) and to characterize these interventions as well as their providers. Method: A systematic review and meta-analyses of randomized controlled trials (RCTs). Primary outcome were symptoms of PTSD. Results: Four RCTs with a total of 774 patients suffering from PTSD symptoms were included, all applying cognitive behavioural based interventions. Three studies with psychological interventions being conducted by case managers were pooled in a meta-analysis. Interventions were not effective in the short term (0–6 months; SMD, − 0.1; 95% CI, − 0.24-0.04; I2 = 0%). Only two studies contributed to the meta-analysis for long term (12–18 months) outcomes yielding a small effect (SMD, − 0.23; 95% CI, − 0.38- -0.08; I2 = 0%). Conclusions: Psychological interventions for PTSD in primary care settings may be effective in the long term but number and quality of included studies was limited so the results should be interpreted with caution. Keywords: PTSD, Primary care, Systematic review
* Correspondence: [email protected] † Rebekka Gehringer, Antje Freytag, Horst Christian Vollmar and Jochen Gensichen contributed equally to this work. 1 Institute of General Practice and Family Medicine, Jena University Hospital, Friedrich-Schiller-University, Bachstr. 18, 07743 Jena, Germany Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http:/
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