Efficacy of interventions for posttraumatic stress disorder symptoms induced by traumatic medical events: a systematic review.

Abstract

Serious medical events are increasingly recognised as potential triggers for posttraumatic stress disorder (PTSD). This systematic review evaluated the efficacy of interventions for medically induced PTSD. Nine electronic databases were searched from inception to November 2023 (PROSPERO ID: CRD42024504055). Eligible studies were randomised controlled trials of interventions for adults diagnosed with, or exhibiting elevated symptoms of, PTSD related to life-threatening medical events. Risk of bias (RoB) was assessed using the Cochrane RoB 2 tool. Group differences at follow-up were assessed using independent t-tests for statistical significance, and Cohen's d was calculated to measure effect sizes. Eleven trials (sample sizes: 17-89) met inclusion criteria, with PTSD primarily resulting from cardiovascular events (n = 5) or cancer (n = 4). Interventions included trauma-focused psychotherapies (n = 8; e.g., Eye Movement Desensitisation and Reprocessing [EMDR]) and others (n = 3; e.g., supportive therapy). Most studies reported significant posttreatment differences and large effect sizes favouring the intervention group, with EMDR and other trauma-focused psychotherapies particularly well-supported. Common limitations included small sample sizes, use of self-reported outcomes, and high dropout rates. Results highlight the efficacy of several interventions for medically induced PTSD and the need for larger trials.