A systematic review on the effectiveness of cognitive behavioral therapy for posttraumatic stress disorder.
OBJECTIVE
Cognitive behavioral therapy (CBT) is the most common psychotherapy approach for the treatment of PTSD. Nevertheless, previous reviews on the efficacy of several types of psychotherapy were unable to detect differences between CBT and other psychotherapies. The purpose of this study was to conduct systematic review on the efficacy ofCBT in comparison with studies that used other psychotherapy techniques.


METHODS
Databases were searched using the following terms: posttraumatic stress disorder/stress disorder, treatment/psychotherapy/behavior cognitive therapy, randomized trials, and adults. Randomized clinical trials published between 1980 and 2005 and that compared CBT with other treatments for PTSD was included. The main outcomes were remission, clinical improvement, dropout rates and changes in symptoms.


RESULTS
The 23 clinical trials included in the review comprised 1923 patients: 898 in the treatment group and 1,025 in the control group. CBT had better remission rates than EMDR (RR = 0.35; 95% CI: 0.16; 0.79; p = 0.01) or supportive therapies (RR = 0.43; 95% CI: 0.25; 0.74; p = 0.002, completer analysis). CBT was comparable to Exposure Therapy (ET) (RR = 0.90; 95% CI: 0.58; 1.40; p = 0.64), and cognitive therapy (CT) (RR = 1.01; 95% CI: 0.67; 1.51; p = 0.98) in terms of efficacy and compliance.


CONCLUSIONS
These findings suggest that specific therapies, such as CBT, exposure therapy and cognitive therapy are equally effective, and more effective than supportive techniques in the treatment of PTSD.
Mendes
Deise D
DD
Universidade Federal de São Paulo, Departamento de Psiquiatria, Brazil. deisedaniela@gmail.com
Mello
Marcelo Feijó
MF
Ventura
Paula
P
Passarela
Cristiane De Medeiros
Cde M
Mari
Jair de Jesus
Jde J
D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D035061:Control Groups; D006801:Humans; D011613:Psychotherapy / Q000379:methods; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome