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An anxiety disorder that develops in reaction to physical injury or severe mental or emotional distress, such as military combat, violent assault, natural disaster, or other life-threatening events.

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Neurotrophic Stimulation Therapy for the Management of Post-Traumatic Stress Disorder and Substance Abuse Disorders: A Review of the Clinical Effectiveness [Internet]

Centers offering a neurotrophic stimulation approach to managing mental health disorders are available in Canada. The objective of this report is to systematically review the literature for evidence of clinical effectiveness for the use of any component of neurotrophic stimulation alone or in combination with another component in patients with post-traumatic stress disorder (PTSD) or substance use disorders. A second report will address the clinical effectiveness of neuromodulation therapy in depression and anxiety disorders.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: July 20, 2015
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An Overview of Complementary and Alternative Medicine Therapies for Anxiety and Depressive Disorders: Supplement to Efficacy of Complementary and Alternative Medicine Therapies for Posttraumatic Stress Disorder [Internet]

VA is committed to expanding the breadth of posttraumatic stress disorder (PTSD)-related services available to Veterans. Since depressive and anxiety disorders share common features with PTSD, this report was commissioned to examine the efficacy of complementary and alternative medicine (CAM) therapies for the treatment of depressive and anxiety disorders as a means to detect treatments that might be applicable to PTSD.

Evidence-based Synthesis Program - Department of Veterans Affairs (US).

Version: August 2011
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Interventions to Improve Pharmacological Adherence Among Adults with Psychotic Spectrum Disorders, Bipolar Disorder, and Posttraumatic Stress Disorder [Internet]

Non-adherence to medication is a serious problem in the United States (US). It is associated with increased emergency department visits and hospitalizations, higher costs of care, and greater mortality. For patients with serious mental illness, including schizophrenia and other psychotic spectrum disorders, bipolar disorder, and posttraumatic stress disorder (PTSD), adherence to psychopharmacological and/or non-psychopharmacological medications is an important concern.

Evidence-based Synthesis Program - Department of Veterans Affairs (US).

Version: November 2015
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Efficacy of Complementary and Alternative Medicine Therapies for Posttraumatic Stress Disorder [Internet]

Posttraumatic stress disorder (PTSD) is the emotional disorder most frequently associated with combat and other potentially traumatic experiences that may occur during military service. It is often chronic and may be associated with significant comorbidities and functional impairments. Current first-line PTSD therapies include trauma-focused cognitive behavioral psychotherapies, stress inoculation training, and pharmacotherapies. Complementary and alternative medicine (CAM) interventions include a range of therapies that are not considered standard to the practice of medicine in the U.S. CAM therapies are widely used by mental health consumers, including Veterans, and numerous stakeholders have expressed strong interest in fostering the evidence base for these approaches in PTSD. Thus, this evidence synthesis was requested by VA Research and Development to inform decisions on the need for research in this area.

Evidence-based Synthesis Program - Department of Veterans Affairs (US).

Version: August 2011
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Virtual Reality Exposure Therapy for Adults with Post-Traumatic Stress Disorder: A Review of the Clinical Effectiveness [Internet]

Post-traumatic stress disorder (PTSD) is a chronic psychiatric condition that develops following an exceptionally traumatic event. Core symptoms of PTSD include re-experiencing the trauma (for example, through flashbacks and nightmares), avoidance of reminders of trauma, and hyperarousal (for example, feeling irritable or angry, startling easily, or experiencing difficulty sleeping or concentrating). Lifetime prevalence rates of PTSD have been estimated as 9.2% in Canada and ranging from 6.8% to 12.3% in the United States. Certain groups of people, such as those exposed to military combat, are at a higher risk of developing PTSD; lifetime prevalence of PTSD in Vietnam war veterans has been reported at 18.7%, and up to 18% of Operation Iraqi Freedom veterans have experienced PTSD.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: August 28, 2014
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Sports and games for post‐traumatic stress disorder

Traumatic events evoke strong feelings of fear, helplessness and anxiety. Many who experience a traumatic event overcome these strong emotions however a proportion does not and the emotional reaction may progress into Post‐Traumatic Stress Disorder (PTSD). Pharmacological and psychological interventions are well known treatments for PTSD but little is known of the use of sports and games for the treatment of PTSD. This review sought to examine studies using sports and games to alleviate symptoms of PTSD.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Psychological therapies for preventing post‐traumatic stress disorder in children and adolescents

Children and adolescents who have experienced trauma are at high risk of developing post‐traumatic stress disorder (PTSD) and negative psychological and social outcomes.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Neuro-Linguistic Programming for the Treatment of Adults with Post-Traumatic Stress Disorder, General Anxiety Disorder, or Depression: A Review of Clinical Effectiveness and Guidelines [Internet]

Post-traumatic stress disorder (PTSD), general anxiety disorder (GAD), and major depression disorder (MDD) are common debilitating disorders with a lifetime prevalence rate of approximately 12%, 2.6%, and 8% of Canadians, respectively. In addition to pharmacologic treatment, different treatment modalities such as psychotherapy, electroconvulsive therapy, transcranial magnetic stimulation, vagus nerve stimulation, deep brain stimulation, and neuro-linguistic programming (NLP), have been suggested for these disorders.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: November 3, 2014
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Screening for Post-Traumatic Stress Disorder (PTSD) in Primary Care: A Systematic Review [Internet]

To minimize treatment delays and to maximize population reach, Veterans Affairs (VA) established a screening program to facilitate identification of post-traumatic stress disorder (PTSD) in their patients as they present in primary care clinics. Such screening programs may be helpful because primary care providers often have difficulty identifying PTSD in their patients and PTSD is frequently undertreated in the primary care setting. The premise of this type of screening program is to facilitate mental health treatment engagement earlier in the course of the illness and to engage patients in treatment who might otherwise not be identified as needing mental health care.

Evidence-based Synthesis Program - Department of Veterans Affairs (US).

Version: January 2013
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The Assessment and Treatment of Individuals with History of Traumatic Brain Injury and Post-Traumatic Stress Disorder: A Systematic Review of the Evidence [Internet]

United States (U.S.) Veterans Affairs (VA) and Department of Defense (DoD) healthcare facilities are increasingly serving a large population of Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) veterans who have sustained traumatic brain injury (TBI), suffer from post-traumatic stress disorder (PTSD), or have both a history of TBI and current PTSD (TBI/PTSD). Mild TBI (mTBI) is considered the most common form of TBI. Uncertainty exists regarding the long-term health outcomes of mTBI as well as the validity of criteria used to assess for a history of this injury. Symptoms that may be attributable to mTBI are similar to symptoms of PTSD. It is unknown whether findings from civilian populations with both a history of mTBI and PTSD (mTBI/PTSD) are applicable to individuals with combat-related mTBI/PTSD. Current evidence-based practices to screen, diagnose, prospectively evaluate, and treat mTBI symptoms or PTSD may be less accurate or effective if and when these conditions co-occur. Thus, there is a need to develop an evidence base to identify best practices to define, diagnose, evaluate, and manage patients with mTBI/PTSD, particularly in U.S. veterans of OEF/OIF.

Evidence-based Synthesis Program - Department of Veterans Affairs (US).

Version: August 2009
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Cancer-Related Post-traumatic Stress (PDQ®): Patient Version

Expert-reviewed information summary about post-traumatic stress and related symptoms in cancer patients, cancer survivors, and their family members. Assessment and treatment of these symptoms are discussed.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: July 7, 2015

Post-Traumatic Stress Disorder: The Management of PTSD in Adults and Children in Primary and Secondary Care

This guideline has been developed to advise on the treatment and management of post-traumatic stress disorder (PTSD). The guideline recommendations have been developed by a multidisciplinary team of healthcare professionals, PTSD sufferers and guideline methodologists after careful consideration of the best available evidence. (The term ‘PTSD sufferer’ was chosen for use in the guideline on the basis of a survey conducted by sufferer members of the Guideline Development Group. People with the disorder were presented with a range of options such as ‘people with PTSD’, ‘patients with PTSD’ and ‘PTSD sufferer’ and asked to indicate which term they preferred; ‘PTSD sufferer’ was the term favoured by the majority.) It is intended that the guideline will be useful to clinicians and service commissioners in providing and planning high-quality care for those with PTSD while also emphasising the importance of the experience of care for patients and their families.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2005
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Cognitive Processing Therapy for Post-Traumatic Stress Disorder: A Systematic Review and Meta-Analysis [Internet]

Post-traumatic stress disorder (PTSD) is characterized by symptoms that include intrusive or distressing thoughts, nightmares, and flashbacks derived from past exposure to traumatic events, such as the sudden death of a loved one, a serious accident, a natural disaster, sexual or physical assault, childhood sexual or physical abuse, combat exposure, or torture. The lifetime prevalence of PTSD in Canada (i.e., the proportion of the population who will experience PTSD in their lifetime) has been estimated to be 9.2%, with higher rates in the armed forces population.

CADTH Health Technology Assessment - Canadian Agency for Drugs and Technologies in Health.

Version: March 2016
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A systematic review to study the efficacy of cognitive behavioral therapy for sexually abused children and adolescents with posttraumatic stress disorder

Bibliographic details: de Medeiros Passarela C, Mendes DD, de Jesus Mari J.  A systematic review to study the efficacy of cognitive behavioral therapy for sexually abused children and adolescents with posttraumatic stress disorder. Revista de Psiquiatria Clinica 2010; 37(2): 69-73

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

A systematic review of the efficacy of adding nonexposure components to exposure therapy for posttraumatic stress disorder

Bibliographic details: Kehle-Forbes SM, Polusny MA, MacDonald R, Murdoch M, Meis LA, Wilt TJ.  A systematic review of the efficacy of adding nonexposure components to exposure therapy for posttraumatic stress disorder. Psychological Trauma: Theory, Research, Practice, and Policy 2013; 5(4): 317-322 Available from: http://psycnet.apa.org/doi/10.1037/a0030040

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Psychological and pharmacological treatments for adults with posttraumatic stress disorder (PTSD)

Bibliographic details: Jonas DE, Cusack K, Forneris CA, Wilkins TM, Sonis J, Middleton JC, Feltner C, Meredith DM, Cavanaugh J, Brownley KA, Olmsted KR, Greenblatt A, Weil A, Gaynes BN.  Psychological and pharmacological treatments for adults with posttraumatic stress disorder (PTSD). Rockville, MD, USA: Agency for Healthcare Research and Quality. Comparative Effectiveness Review; 92. 201323658937

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Medical Marijuana for Post-Traumatic Stress Disorder: A Review of Clinical Effectiveness and Guidelines [Internet]

The purpose of this Rapid Response report is to summarize the evidence of clinical efficacy for medical marijuana and synthetic cannabinoids in adult populations with PTSD, and identify any evidence-based guidelines for this population.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: January 11, 2017
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Interventions for the prevention of posttraumatic stress disorder (PTSD) in adults after exposure to psychological trauma

Bibliographic details: Gartlehner G, Forneris CA, Brownley KA, Gaynes BN, Sonis J, Coker-Schwimmer E, Jonas DE, Greenblatt A, Wilkins TM, Woodell CL, Lohr KN.  Interventions for the prevention of posttraumatic stress disorder (PTSD) in adults after exposure to psychological trauma. Rockville, MD, USA: Agency for Healthcare Research and Quality. Comparative Effectiveness Review; 109. 2013 Available from: http://effectivehealthcare.ahrq.gov/ehc/products/403/1444/PTSD-prevention-executive-130327.pdf

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Mindfulness Interventions for the Treatment of Post-Traumatic Stress Disorder, Generalized Anxiety Disorder, Depression, and Substance Use Disorders: A Review of the Clinical Effectiveness and Guidelines [Internet]

Mindfulness is an integrative, mind-body based approach that helps people change the way they think and feel about their experiences. It is a way of paying attention to the present moment by using meditation, breathing techniques, and yoga. Mindfulness involves consciously bringing awareness to thoughts and feelings, without making judgments , allowing the individual to become less enmeshed and better able to manage them. The objective of this review is to summarize the clinical effectiveness and guidelines for the use of mindfulness interventions for the treatment of post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD), depression, and substance use disorders in adults.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: June 19, 2015
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Treatment for Post-Traumatic Stress Disorder, Operational Stress Injury, or Critical Incident Stress: A Review of Guidelines [Internet]

Critical incidents are events where individuals witness or experience tragedy, death, serious injuries, or threatening situations, which may have strong emotional impact. Emergency service workers and law enforcement workers are often affected by critical incident stress (CIS), which may or may not develop a post-traumatic stress disorders (PTSD) after a critical incident or traumatic event. The signs and symptoms of CIS can be physical (e.g., fatigue, headache, dizziness), cognitive (e.g., confusion, nightmares, poor attention and concentration), emotional (e.g., fear, guilt, anger, depression, chronic anxiety) and behavioral (e.g., restlessness, withdrawal, increased alcohol consumption). Tools for the management of CIS include demobilization, crisis management briefings, defusing, and debriefing.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: April 27, 2015
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