An Evidence-Based Review of Early Intervention and Prevention of Posttraumatic Stress Disorder

Abstract

We present an evidence-based review of post-trauma interventions used to prevent posttraumatic stress disorder (PTSD). Literature search of PubMed from 1988 to March 2016 using keywords "Early Intervention AND Prevention of PTSD" yielded 142 articles, of which 52 intervention studies and 6 meta-analyses were included in our review. Trauma-focused cognitive behavioral therapy and modified prolonged exposure delivered within weeks of a potentially traumatic event for people showing signs of distress have the most evidence in the treatment of acute stress and early PTSD symptoms, and the prevention of PTSD. Even though several pharmacological agents have been tried, only hydrocortisone prior to high-risk surgery, severe traumatic injury, or during acute sepsis has adequate evidence for effectiveness in the reduction of acute stress symptoms and prevention of PTSD. There is an urgent need to determine the best targets for interventions after trauma to accelerate recovery and prevent PTSD.

Frühinterventionen nach Traumatisierung

“…Für den Einsatz von Hydrokortison liegt eine moderate Empfehlung vor, im Vergleich zum Verzicht auf eine Intervention und Placebogabe (Risk Ratio = 0,17) [10] [11] [12]. Mehrere Übersichtsarbeiten kommen jedoch zu dem Schluss, dass qualitativ hochwertige Studien notwendig sind, um die Eignung der diskutierten Substanzen zur Prävention einer PTBS beurteilen zu können [13].…”

Is a Doctor Like a Toaster? Earning Trust in the Profession of Medicine

“…New scientific discoveries have prompted changes in clinical practices involving prevention, early identification and intervention, and surveillance. These changes have led to increased survival and enhanced quality of life in patients with infectious diseases [23]; cardiac disease [24]; lung, breast, colon, and prostate cancers [25]; diabetes [26]; and, also importantly, mental disorders [27,28]. Looking ahead, advancing efforts to improve health outcomes and transform quality and safety standards have emerged as a foremost commitment across the entire US health care system [29].…”

Continuance Group Intervention Protocol (CGIP) for a Unique Intervention

“…Second, because the CGI was conducted by the military and aimed to mitigate distress among all soldiers, a random sample could not be attained, meaning that this study was not designed for systematic research. Third, we did not compare our intervention to other well established intervention modalities such as trauma-focused cognitive behavioral therapy and modified prolonged exposure delivered within weeks of a potentially traumatic event (Birur et al, 2017). Future research is needed in order to ilumunate the advantages of our proposed intervention.…”