Table 3Eligibility criteria

CategoryInclusionExclusion
PopulationAdults with PTSD based on “Diagnostic and Statistical Manual of Mental Disorders” criteria
  • Children
  • People at risk of developing PTSD
  • People with subsyndromal PTSD
InterventionsPsychological interventions including:
  • Brief eclectic psychotherapy
  • Cognitive-behavioral therapy, such as cognitive restructuring, cognitive processing therapy, exposure-based therapies, and coping skills therapy (may include components such as stress inoculation training, assertiveness training, biofeedback [including brainwave neurofeedback], or relaxation training)
  • Eye movement desensitization and reprocessing
  • Hypnosis or hypnotherapy
  • Interpersonal therapy
  • Psychodynamic therapy
Pharmacological interventions including:
  • Selective serotonin reuptake inhibitors (SSRIs: citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline)
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs: desvenlafaxine, venlafaxine, and duloxetine)
  • Other second-generation antidepressants (bupropion, mirtazapine, nefazodone, and trazodone)
  • Tricyclic antidepressants (imipramine, amitriptyline, and desipramine)
  • Alpha blockers (prazosin)
  • Atypical antipsychotics (olanzapine and risperidone)
  • Benzodiazepines (alprazolam, diazepam, lorazepam, and clonazepam)
  • Anticonvulsants/mood stabilizers (topiramate, tiagabine, lamotrigine, carbamazepine, and divalproex)
  • Complementary and alternative medicine approaches
  • Psychological or pharmacological interventions not listed as included
ComparatorsBy KQ:
  • KQ 1: Psychological interventions listed above compared with one another or with waitlist assignment, usual care (as defined by the study), no intervention, or sham
  • KQ 2: Pharmacological interventions listed above compared with one another or to placebo
  • KQ 3: Psychological interventions listed above compared with pharmacologic interventions listed above
  • KQ 4: Combinations of psychological and pharmacological interventions compared with either one alone (placebo, waitlist assignment, usual care, no intervention, or sham may be used in conjunction with the monotherapy arm)
  • KQs 5 and 6: All studies including the comparators for KQs 1 through 4 will be eligible
Outcomes
  • PTSD symptom reduction, both assessor-rated and self-reported: as measured by the Clinician-Administered PTSD Scale (CAPS), and previous versions of the CAPS, such as the Clinician-Administered PTSD Scale Part 2 (CAPS-2); the Impact of Event Scale (IES); the Impact of Event Scale–Revised (IES-R); the Modified PTSD Symptom Scale (MPSS-SR); the self-rated PTSD symptoms Checklist (PCL); the PTSD Symptom Scale–Interview (PSS-I); the PTSD Symptom Scale–Self-report Version (PSS-SR); or the Structured Interview for PTSD (SI-PTSD)
  • Prevention or reduction of comorbid medical or psychiatric conditions (e.g., coronary artery disease; depressive symptoms; anxiety symptoms; suicidal ideation, plans, or attempts; and substance use, abuse, or dependence)
  • Remission (no longer having symptoms)
  • Loss of PTSD diagnosis
  • Quality of lifea
  • Disability or functional impairmenta
  • Return to work or return to active duty
  • Adverse events: overall adverse events, withdrawals due to adverse events, and specific adverse events (including, but not limited to, disturbed sleep, increased agitation, sedation, weight gain, metabolic side effects, and mortality)
Publication languageEnglishAll other languages
Time period1980 to present; searches to be updated after draft report goes out for peer review
Time period1980 to present; searches to be updated after draft report goes out for peer review
Settings
  • Outpatient and inpatient primary care or specialty mental health care settings
  • Community settings (e.g., churches, community health centers, rape crisis centers)
  • Military settings
GeographyNo limits
Study durationAt least 4 weeks from the time of group assignment for trials
Admissible evidence for KQs 1 through 5Original research
Randomized controlled trials with no sample size limit
For KQ 5 (focused on whether any treatment approaches for PTSD are more effective than others for victims of particular types of trauma), information within the trials meeting inclusion criteria for KQs 1 through 4
  • Observational studies
  • Systematic reviews and meta-analyses
  • Nonsystematic reviews
  • Editorials
  • Letters to the editor
  • Articles rated as high risk of biasb
Admissible evidence for KQ 6 (adverse effects)
  • Data from trials included in KQs 1 through 4 that reported adverse effects
  • Nonrandomized controlled trials of any sample size
  • Prospective cohort studies with an eligible comparison group with a sample size of at least 500
  • Case-control studies with a sample size of at least 500
  • Case series
  • Case reports
  • Systematic reviews and meta-analyses
  • Nonsystematic reviews
  • Editorials
  • Letters to the editor
  • Articles rated as high risk of biasb
  • Studies with historical, rather than concurrent, control groups
  • Pre/post studies without a separate control group

From: Methods

Cover of Psychological and Pharmacological Treatments for Adults With Posttraumatic Stress Disorder (PTSD)
Psychological and Pharmacological Treatments for Adults With Posttraumatic Stress Disorder (PTSD) [Internet].
Comparative Effectiveness Reviews, No. 92.
Jonas DE, Cusack K, Forneris CA, et al.

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