Early treatment is beneficial for patients with PTSD

Clinical question Is early treatment after a traumatic stress event beneficial?

Bottom line Identification of a traumatic stress event within 3 months and treatment using trauma-focused cognitive behavioral therapy (CBT) is beneficial for patients who meet DSM-IV criteria for the diagnosis of posttraumatic stress disorder (PTSD). It is uncertain whether individuals would benefit if they are symptomatic but do not meet diagnostic criteria for PTSD. (Level of evidence = 1a–)

Synopsis This is a meta-analysis of randomized controlled trials of psychological interventions (of more than one session) to reduce traumatic stress symptoms within 3 months of a traumatic stress event compared with pla cebo or other control (eg, waiting list or usual care). The authors identified 25 studies that met inclusion criteria. Intervention for individuals involved in a traumatic event, irrespective of symptoms, showed no difference between any intervention and control groups. Among individuals with traumatic stress symptoms irrespective of symptoms, trauma-focused CBT was more effective than waiting list or supportive counseling (relative risk [RR] = 0.72; 95% CI, 0.50-1.05), especially those meeting criteria for diagnosis of PTSD (RR = 0.54; 0.31-0.95). Trauma-focused CBT was defined as “any intervention that focused on the trauma using exposure to trauma memories and trauma reminders with or without cognitive therapy and other cognitive-behavioral techniques.”