Meta-analysis of the treatment of posttraumatic stress disorder in adults with comorbid severe mental illness

This study evaluated the efficacy of psychosocial treatments for posttraumatic stress disorder (PTSD) among individuals with a comorbid severe mental illness.

Article Abstract

“Objective: To evaluate the efficacy of psychosocial treatments for posttraumatic stress disorder (PTSD) among individuals with a comorbid severe mental illness (SMI; ie, schizophrenia, bipolar disorder, major depressive disorder).

Data Sources: PubMed, PsycINFO, CINAHL, and Cochrane Library were searched from January 1998 to March 2020 using keywords related to PTSD, treatment, and severe mental illness.

Study Selection: All clinical trials for PTSD psychotherapy among individuals with SMI were included. From 38 potentially eligible studies, a total of 14 clinical trials across 684 individuals with comorbid SMI and PTSD were identified and included in the analysis.

Data Extraction: Data on demographic, SMI diagnosis, symptom severity, sample attrition, and treatment protocol received were extracted. Effect size calculations and subsequent meta-analyses were conducted using the Meta-Analysis Package for R (metafor) version 2.1–0 in R (3.6.0).

Results: PTSD treatments had a large effect on PTSD outcomes among individuals with SMI, with patients experiencing a standard deviation reduction in PTSD symptomatology pre- to post-treatment (g = −1.009, P < .001, k = 34). Prolonged exposure (g = −1.464; P < .001; SE = 0.276; k = 5), eye movement desensitization and reprocessing (g = −1.351; P < .001; SE = 0.276; k = 5), and brief treatment program (g = −1.009; P < .001; SE = 0.284; k = 5) had the largest effects on PTSD symptoms.

Conclusions: Although underrepresented in the PTSD literature, PTSD psychotherapies are effective for individuals with SMI. Treatments with an exposure-based component may have greater efficacy in this clinical population.”

—Description from publisher

Article Access

Open Access

Grubaugh, A. L., Brown, W. J., Wojtalik, J. A., Myers, U. S., & Mack, S. M. (2021). Meta-analysis of the treatment of posttraumatic stress disorder in adults with comorbid severe mental illness. The Journal of Clinical Psychiatry, 82(3), 20r13584. Open access: https://doi.org/10.4088/jcp.20r13584

About the Journal

The Journal of Clinical Psychiatry (JCP), an international peer-reviewed journal, is the official publication of the American Society of Clinical Psychopharmacology.

—Description from publisher