Interventions for posttraumatic stress disorder symptoms induced by medical events: A systematic review

Mytra Haerizadeh, Jennifer A. Sumner, Jeffrey L. Birk, Christopher Gonzalez, Reuben Heyman-Kantor, Louise Falzon, Liliya Gershengoren, Peter Shapiro, Ian M. Kronish

Research output: Contribution to journalReview articlepeer-review

17 Scopus citations

Abstract

Objective: Medical events such as myocardial infarction and cancer diagnosis can induce symptoms of posttraumatic stress disorder (PTSD). The optimal treatment of PTSD symptoms in this context is unknown. Methods: A literature search of 6 biomedical electronic databases was conducted from database inception to November 2018. Studies were eligible if they used a randomized design and evaluated the effect of treatments on medical event-induced PTSD symptoms in adults. A random effects model was used to pool data when two or more comparable studies were available. Results: Six trials met full inclusion criteria. Studies ranged in size from 21 to 81 patients, and included patients with PTSD induced by cardiac events, cancer, HIV, multiple sclerosis, and stem cell transplantation. All trials assessed psychological interventions. Two trials comparing a form of exposure-based cognitive behavioral therapy (CBT) with assessment-only control found that CBT resulted in lower PTSD symptoms [Hedges's g = −0.47, (95% CI -0.82 – −0.12), p =.009]. A third trial compared imaginal exposure (another form of exposure-based CBT) with an attention control and found a trend toward reduced PTSD symptoms. Three trials compared eye movement desensitization and reprocessing (EMDR) with active psychological treatments (imaginal exposure, conventional CBT, and relaxation therapy), and found that EMDR was more effective. Conclusion: CBT and EMDR may be promising approaches to reducing PTSD symptoms due to medical events. However, additional trials are needed in this patient population.

Original languageEnglish
Article number109908
JournalJournal of Psychosomatic Research
Volume129
DOIs
StatePublished - Feb 2020
Externally publishedYes

Keywords

  • Cognitive behavioral therapy
  • Eye-movement desensitization and reprocessing
  • Medical event-induced PTSD
  • Posttraumatic stress disorder
  • Psychotherapy
  • Treatment

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