Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2014 Jul 8;2014(7):CD006239.
doi: 10.1002/14651858.CD006239.pub2.

Pharmacological interventions for preventing post-traumatic stress disorder (PTSD)

Taryn Amos  1 , Dan J Stein, Jonathan C Ipser
Affiliations
Meta-Analysis

Pharmacological interventions for preventing post-traumatic stress disorder (PTSD)

Taryn Amos et al. Cochrane Database Syst Rev. .

Abstract

Background: Post-traumatic stress disorder (PTSD) is a debilitating disorder which, after a sufficient delay, may be diagnosed amongst individuals who respond with intense fear, helplessness or horror to traumatic events. There is some evidence that the use of pharmacological interventions immediately after exposure to trauma may reduce the risk of developing of PTSD.

Objectives: To assess the effects of pharmacological interventions for the prevention of PTSD in adults following exposure to a traumatic event.

Search methods: We searched the Cochrane Depression, Anxiety and Neurosis Controlled Trials Register (CCDANCTR-Studies and CCDANCTR-References) (to 14 February 2014). This register contains relevant reports of randomised controlled trials from the following bibliographic databases: CENTRAL (all years); EMBASE (1974 to date); MEDLINE (1950 to date) and PsycINFO (1967 to date). We identified unpublished trials by searching the National Institute of Health (NIH) Reporter, the metaRegister of Controlled Trials database (mRCT) and the WHO International Clinical Trials Registry Platform (to December 2013). We scanned the reference lists of articles for additional studies. We placed no constraints on language and setting.

Selection criteria: We restricted studies to randomised controlled trials (RCTs) of pharmacological interventions compared with placebo for the prevention of PTSD in adults.

Data collection and analysis: Two authors (TA and JI) independently assessed trials for eligibility and inclusion based on the review selection criteria. We independently extracted sample, methodological, outcome and 'Risk of bias' data, as well as the number of side effects, from each trial and entered these into a customised data extraction form. We contacted investigators for missing information. We calculated summary statistics for continuous and dichotomous variables (if provided). We did not undertake subgroup analyses due to the small number of included studies.

Main results: We included nine short-term RCTs (duration 12 weeks or less) in the analysis (345 participants; age range 18 to 76 years). Participants were exposed to a variety of traumas, ranging from assault, traffic accidents and work accidents to cardiac surgery and septic shock. Seven studies were conducted at single centres. The seven RCTs included four hydrocortisone studies, three propranolol studies (of which one study had a third arm investigating gabapentin), and single trials of escitalopram and temazepam. Outcome assessment measures included the Clinician-Administered PTSD Scale (CAPS), the 36-Item Short-Form Health Survey (SF-36) and the Center for Epidemiological Studies - Depression Scale (CES-D).In four trials with 165 participants there was moderate quality evidence for the efficacy of hydrocortisone in preventing the onset of PTSD (risk ratio (RR) 0.17; 95% confidence interval (CI) 0.05 to 0.56; P value = 0.004), indicating that between seven and 13 patients would need to be treated with this agent in order to prevent the onset of PTSD in one patient. There was low quality evidence for preventing the onset of PTSD in three trials with 118 participants treated with propranolol (RR 0.62; 95% CI 0.24 to 1.59; P value = 0.32). Drop-outs due to treatment-emergent side effects, where reported, were low for all of the agents tested. Three of the four RCTs of hydrocortisone reported that medication was more effective than placebo in reducing PTSD symptoms after a median of 4.5 months after the event. None of the single trials of escitalopram, temazepam and gabapentin demonstrated evidence that medication was superior to placebo in preventing the onset of PTSD.Seven of the included RCTs were at a high risk of bias. Differential drop-outs between groups undermined the results of three studies, while one study failed to describe how the allocation of medication was concealed. Other forms of bias that might have influenced study results included possible confounding through group differences in concurrent medication and termination of the study based on treatment response.

Authors' conclusions: There is moderate quality evidence for the efficacy of hydrocortisone for the prevention of PTSD development in adults. We found no evidence to support the efficacy of propranolol, escitalopram, temazepam and gabapentin in preventing PTSD onset. The findings, however, are based on a few small studies with multiple limitations. Further research is necessary in order to determine the efficacy of pharmacotherapy in preventing PTSD and to identify potential moderators of treatment effect.

PubMed Disclaimer

Conflict of interest statement

Potential conflicts of interest for individual review authors

Taryn Amos has no known conflict of interest outside of her employment by the MRC Unit on Anxiety and Stress Disorders.

Jonathan Ipser has no known conflict of interest.

Dan Stein has received research grants and/or consultancy honoraria from AstraZeneca, Eli‐Lilly, GlaxoSmithKline, Lundbeck, Orion, Pfizer, Pharmacia, Roche, Servier, Solvay, Sumitomo and Wyeth. He has participated in a number of ongoing studies and has presented data from some of these studies on behalf of the sponsoring companies.

Figures

1
1
Flow diagram.
2
2
'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1 Propranolol versus placebo, Outcome 1 Treatment efficacy.
1.2
1.2. Analysis
Comparison 1 Propranolol versus placebo, Outcome 2 Sensitivity analysis ‐ observed cases.
2.1
2.1. Analysis
Comparison 2 Hydrocortisone versus placebo, Outcome 1 Treatment efficacy.
2.2
2.2. Analysis
Comparison 2 Hydrocortisone versus placebo, Outcome 2 Sensitivity analysis ‐ observed cases.
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

References to studies included in this review

Delahanty 2012 {published data only}
    1. Delahanty DL, Gabert‐Quillen C, Ostrowski SA, Nugent NR, Fischer B, Morris A, et al. The efficacy of initial hydrocortisone administration at preventing posttraumatic distress in adult trauma patients: a randomized trial. CNS Spectrums 2013;18:103‐11. - PMC - PubMed
    1. Delahanty DL, Ostrowski S, Nugent N, Gabert C, Fallon W. Hydrocortisone as a secondary intervention to prevent subsequent PTSD symptoms [conference abstract]. Psychosomatic Medicine [abstracts from the 69th Annual Meeting of the American Psychosomatic Society; 2011 Mar 9‐12; San Antonio, TX United States] 2011;73(3):A107.
Hoge 2012 {published data only}
    1. Hoge EA, Worthington JJ, Nagurney JT, Chang Y, Kay EB, Feterowski CM, et al. Effect of acute posttrauma propranolol on PTSD outcome and physiological responses during script‐driven imagery. CNS Neuroscience and Therapeutics 2012;18(1):21‐7. - PMC - PubMed
Mellman 2002 {published data only}
    1. Mellman TA, Bustamante V, Daniella D, Fins AI. Hypnotic medication in the aftermath of trauma. Journal of Clinical Psychiatry 2002;63(12):1183‐4. - PubMed
    1. Mellman TA, Byers PM, Augenstein JS. Pilot evaluation of hypnotic medication during acute traumatic stress response. Journal of Traumatic Stress 1998;11(3):563‐9. - PubMed
Pitman 2002 {published data only}
    1. Pitman RK, Sanders KM, Zusman RM, Healy AR, Cheema F, Lasko NB, et al. Pilot study of secondary prevention of posttraumatic stress disorder with propranolol. Biological Psychiatry 2002;51:189‐92. - PubMed
Schelling 2001 {published data only}
    1. Schelling G, Briegal J, Roozendaal B, Stoll C, Rothenhausler H‐B, Kapfhammer HP. The effect of stress doses of hydrocortisone during septic shock on post traumatic stress disorder in survivors. Biological Psychiatry 2001;50:978‐85. - PubMed
    1. Schelling G, Stoll C, Kapfhammer HP, Rothenhäusler HB, Krauseneck T, Durst K, et al. The effect of stress doses of hydrocortisone during septic shock on posttraumatic stress disorder and health‐related quality of life in survivors. Critical Care Medicine 1999;27(12):2678‐83. - PubMed
    1. Schelling G, Stoll C, Wichmann A, Haller M, Schuffel W, Briegel J. The effect of hydrocortisone (HC) during septic shock on incidence and intensity of post‐traumatic stress disorder (PTSD) in long term survivors. Critical Care Medicine 1998;26(1):131A.
Shalev 2012 {published data only}
    1. Galatzer‐Levy IR, Ankri Y, Freedman S, Israeli‐Shalev Y, Roitman P, Gilad M, et al. Early PTSD symptom trajectories: persistence, recovery, and response to treatment: results from the Jerusalem trauma outreach and prevention study (J‐TOPS). PloS One 2013;8(8):e70084. - PMC - PubMed
    1. Shalev AY, Ankri Y, Israeli‐Shalev Y, Peleg T, Adessky R, Freedman S. Prevention of posttraumatic stress disorder by early treatment: results from the Jerusalem Trauma Outreach And Prevention study. Archives of General Psychiatry 2012;69(2):166‐76. - PubMed
    1. Shalev AY, Ankri YL, Peleg T, Israeli‐Shalev Y, Freedman S. Barriers to receiving early care for PTSD: results from the Jerusalem trauma outreach and prevention study. Psychiatric Services 2011;62:765–73. - PubMed
Stein 2007 {published data only}
    1. Stein MB, Kerridge C, Dimsdale JE, Hoyt DB. Pharmacotherapy to prevent PTSD: results from a randomised controlled proof‐of‐concept trial in physically injured patients. Journal of Traumatic Stress 2007;20(6):923‐32. - PubMed
Weis 2006 {published data only}
    1. Weis F, Kilger E, Roozendaal B, Quervain D‐F, Lamm P, Schmidt M, et al. Stress doses of hydrocortisone reduce chronic stress symptoms and improve health‐related quality of life in high‐risk patients after cardiac surgery: a randomized study. Cardiopulmonary Support and Physiology 2006;131:277‐82. - PubMed
Zohar 2011a {published data only}
    1. Zohar J, Yahalom H, Kozlovsky N, Cwikel‐Hamzany S, Matar MA, Kaplan Z, et al. High dose hydrocortisone immediately after trauma may alter the trajectory of PTSD: interplay between clinical and animal studies. European Neuropsychopharmacology 2011;21:796–809. - PubMed

References to studies excluded from this review

Davidson 2000 {published data only}
    1. Davidson J, Londborg P, Pearlstein T, Rothbaum B, Brady K, Farfel G. Sertraline and posttraumatic stress disorder: results of 24 weeks of open‐label sertraline followed by a 28‐week discontinuation study. European Neuropsychopharmacology 2000;10(Suppl 3):S349.
Gelpin 1996 {published data only}
    1. Gelpin E, Bonne O, Peri T, Brandes D, Shalev AY. Treatment of recent trauma survivors with benzodiazepines: a prospective study. Journal of Clinical Psychiatry 1996;57(9):390‐4. - PubMed
Martenyi 2002 {published data only}
    1. Martenyi F, Brown EB, Zhang H, Koke SC, Prakash A. Fluoxetine v. placebo in prevention of relapse in post‐traumatic stress disorder. British Journal of Psychiatry 2002;181:315‐20. - PubMed
Martenyi 2006 {published data only}
    1. Martenyi F, Brown EB, Zhang H, Prakash A, Koke SC. Fluoxetine versus placebo in posttraumatic stress disorder. Journal of Clinical Psychiatry 2002;63(3):199‐206. - PubMed
    1. Martenyi F, Soldatenkova V. Fluoxetine in the acute treatment and relapse prevention of combat‐related post‐traumatic stress disorder: analysis of the veteran group of a placebo‐controlled randomized clinical trial. European Neuropsychopharmacology 2006;16(5):340‐9. - PubMed
Schelling 2004 {published data only}
    1. Schelling G, Kilger E, Roozendaal B, Quervain DJ‐F, Briegel J, Dagge A, et al. Stress doses of hydrocortisone, traumatic memories, and symptoms of posttraumatic stress disorder in patients after cardiac surgery: a randomized study. Society of Biological Psychiatry 2004;55:627–33. - PubMed
Vaiva 2003 {published data only}
    1. Vaiva G, Ducrocq F, Jezequel K, Averland B, Lestavel P, Brunet A, et al. Immediate treatment with propranolol decreases posttraumatic stress disorder two months after trauma. Society of Biological Psychiatry 2003;54:947‐9. - PubMed

References to studies awaiting assessment

Azad 2007 {unpublished data only}
    1. Azad S, Shelling G. Influence of Hydrocortisone on Immunologic Markers and Health Care Related Quality of Life in Patients After Cardiac Surgery. http://clinicaltrials.gov/ct2/show/NCT00490828 2007 (accessed 12 March 2014).
    1. Hauer D, Weis F, Campolongo P, Schopp M, Beiras‐Fernandez A, Strewe C, et al. Glucocorticoid‐endocannabinoid interaction in cardiac surgical patients: relationship to early cognitive dysfunction and late depression. Reviews in the Neurosciences 2012;23(5‐6):681‐90. - PubMed
Marx 2006 {unpublished data only}
    1. Marx CE. Secondary Prevention With Paroxetine vs. Placebo in Subthreshold Posttraumatic Stress Disorder (PTSD). http://clinicaltrials.gov/ct2/show/NCT00560612 2007 (accessed 12 March 2014).
Simon 2005 {unpublished data only}
    1. Simon NM. SSRI Administration to Reduce Acute Stress Disorder Symptoms and Prevent Depression and PTSD in Physical Trauma Victims. http://clinicaltrials.gov/ct2/show/NCT00114374 2005 (accessed 12 March 2014).

References to ongoing studies

Zohar 2009 {unpublished data only}
    1. Zohar J. PTSD Prevention Using Escitalopram. http://clinicaltrials.gov/ct2/show/NCT00300313 2006 (accessed 12 March 2014).
Zohar 2010 {unpublished data only}
    1. Zohar J. The Efficacy of a Single Dose of Intranasal Oxytocin in the Prevention of Post Traumatic Stress Disorder (PTSD). http://clinicaltrials.gov/ct2/show/NCT01039766 2009, issue accessed 12 March 2014.
Zohar 2011b {published data only}
    1. Zohar J. Efficacy of Single Dose IV Hydrocortisone in Post Traumatic Stress Disorder (PTSD) Prevention. http://clinicaltrials.gov/ct2/show/NCT00855270 2009 (accessed 12 March 2014).
    1. Zohar J. Randomized placebo‐controlled trial of hydrocortisone in PTSD prophylaxis. http://projectreporter.nih.gov; Project Number: 4R01MH086570‐03 (accessed 12 March 2014).

Additional references

APA 1994
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th Edition. Washington, DC: American Psychiatric Association, 1994.
Beck 1961
    1. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Archives of General Psychiatry 1961;4:561‐71. - PubMed
Besnard 2012
    1. Besnard A, Caboche J, Laroche S. Reconsolidation of memory: a decade of debate. Progress in Neurobiology 2012;99(1):61‐80. - PubMed
Bisson 2010
    1. Bisson J. Post‐traumatic stress disorder. Clinical Evidence 2010;2:1‐62. - PMC - PubMed
Blake 1995
    1. Blake DD, Weathers FW, Nagy LM, Kaloupek DG, Gusman FD, Charney DS, et al. The development of a clinician‐administered PTSD scale. Journal of Traumatic Stress 1995;8(1):75‐90. - PubMed
Bremner 2004
    1. Bremner JD, Vermetten E. Neuroanatomical changes associated with pharmacotherapy in posttraumatic stress disorder. Annals of the New York Academy of Science 2004;1032:154‐7. - PubMed
Brewin 2000
    1. Brewin CR, Andrews B, Valentine JD. Meta‐analysis of risk factors for posttraumatic stress disorder in trauma‐exposed adults. Journal of Consulting and Clinical Psychology 2000;68(5):748‐66. - PubMed
Brunet 2008
    1. Brunet A, Orr SP, Tremblay J, Robertson K, Nader K, Pitman RK. Effect of post‐retrieval propranolol on psychophysiologic responding during subsequent script‐driven traumatic imagery in post‐traumatic stress disorder. Journal of Psychiatric Research 2008;42:503–6. - PubMed
Brunet 2011
    1. Brunet A, Poundja J, Tremblay J, Bui E, Thomas E, Orr SP, et al. Trauma reactivation under the influence of propranolol decreases posttraumatic stress symptoms and disorder: 3 open‐label trials. Journal of Clinical Psychopharmacology 2011;31:547‐50. - PubMed
Bryant 2003
    1. Bryant RA. Early predictors of posttraumatic stress disorder. Biological Psychiatry 2003;53:789‐95. - PubMed
de Jong 2001
    1. Jong JTVM, Komproe IH, Ommeren M, Masri MEI, Araya M, Khaled N, et al. Lifetime events and posttraumatic stress disorder in 4 postconflict settings. American Medical Association 2001;286:555‐62. - PubMed
de Quervain 2009
    1. Quervain DJF, Aerni A, Schelling G, Roozendaal B. Glucocorticoids and the regulation of memory in health and disease. Frontiers in Neuroendocrinology 2009;30:358‐70. - PubMed
De Silva 2009
    1. Silva M, MacLachlan M, Devane D, Desmond D, Gallagher P, Schnyder U, et al. Psychosocial interventions for the prevention of disability following traumatic physical injury. Cochrane Database of Systematic Reviews 2009, Issue 4. [DOI: 10.1002/14651858.CD006422.pub3] - DOI - PMC - PubMed
Dechartres 2011
    1. Dechartres A, Boutron I, Trinquart L, Charles P, Ravaud P. Single‐center trials show larger treatment effects than multicenter trials: evidence from a meta‐epidemiologic study. Annals of Internal Medicine 2011;155:39‐51. - PubMed
Deeks 2001
    1. Deeks JJ, Altman DG. Effect measures for meta‐analysis of trials with binary outcomes. In: Egger M, Davey Smith G, Altman DG editor(s). Systematic Reviews in Health Care: Meta‐analysis in Context. 2nd Edition. London (UK): BMJ Publication Group, 2001.
Deeks 2002
    1. Deeks JJ. Issues in the selection of a summary statistic for meta‐analysis of clinical trials with binary outcomes. Statistics in Medicine 2002;21(11):1575‐600. - PubMed
Deeks 2011
    1. Deeks JJ, Higgins JPT, Altman DG (editors). Chapter 9: Analysing data and undertaking meta‐analyses. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011.
Del Re 2013 [Computer program]
    1. Del Re, AC. compute.es: Compute Effect Sizes. R package version 0.2‐2. http://cran.r‐project.org/web/packages/compute.es, 2013.
Egger 1997
    1. Egger M, Smith GD, Schneider M, Minder C. Bias in meta‐analysis detected by a simple, graphical test. BMJ 1997;315:629‐34. - PMC - PubMed
Elbourne 2002
    1. Elbourne ER, Altman DG, Higgins JPT, Curtin F, Worthington HV, Vail A. Meta‐analyses involving cross‐over trials: methodological issues. International Journal of Epidemiology 2002;31:140‐9. - PubMed
Erbes 2007
    1. Erbes C, Westermeyer J, Engdahl B, Johnsen E. Post‐traumatic stress disorder and service utilization in a sample of service members from Iraq and Afghanistan. Military Medicine 2007;172(4):359‐63. - PubMed
Forneris 2013
    1. Forneris CA, Gartlehner G, Brownley KA, Gaynes BN, Sonis J, Coker‐Schwimmer E, et al. Interventions to prevent post‐traumatic stress disorder: a systematic review. American Journal of Preventive Medicine 2013;44(6):635–50. - PubMed
Gillies 2012
    1. Gillies D, Taylor F, Gray C, O'Brien L, D'Abrew N. Psychological therapies for the treatment of post‐traumatic stress disorder in children and adolescents. Cochrane Database of Systematic Reviews 2012, Issue 12. [DOI: 10.1002/14651858.CD006726.pub2] - DOI - PubMed
Guy 1976
    1. Guy W. ECDEU Assessment Manual for Psychopharmacology. Washington, DC: US National Institutes of Health, 1976.
Hamilton 1959
    1. Hamilton M. The assessment of anxiety states by rating. British Journal of Medical Psychology 1959;32:50‐5. - PubMed
Hamilton 1960
    1. Hamilton M. A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 1960;23:56‐62. - PMC - PubMed
Hebert 1996
    1. Hebert MA, Potegal M, Moore T, Evenson AR, Meyerhoff JL. Diazepam enhances conditioned defeat in hamsters (Mesocricetus auratus). Pharmacology, Biochemistry and Behavior 1996;55(3):405‐13. - PubMed
Heinzelmann 2013
    1. Heinzelmann M, Gill J. Epigenetic mechanisms shape the biological response to trauma and risk for PTSD: a critical review. Nursing Research and Practice 2013;2013:417010. - PMC - PubMed
Higgins 2003
    1. Higgins JT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analyses. BMJ 2003;327(6):557‐60. - PMC - PubMed
Higgins 2011a
    1. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Higgins 2011b
    1. Higgins JPT, Deeks JJ, Altman DG. Chapter 16: Special topics in statistics. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011.
Ipser 2011
    1. Ipser JC, Stein DJ. Evidence‐based pharmacotherapy of post‐traumatic stress disorder (PTSD). International Journal of Neuropsychopharmacology 2011;15(6):825‐40. [DOI: 10.1017/S1461145711001209] - DOI - PubMed
Kessler 1995
    1. Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB. Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry 1995;52(12):1048‐60. - PubMed
Kessler 2005
    1. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age‐of‐onset distributions of DSM‐IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 2005;62(2):593‐602. - PubMed
Krystal 2009
    1. Krystal JH, Neumeister A. Noradrenergic and serotonergic mechanisms in the neurobiology of posttraumatic stress disorder and resilience. Brain Research 2009;1293:13‐23. - PMC - PubMed
Lumley 2000
    1. Lumley LA, Charles RF, Charles RC, Hebert MA, Morton DM, Meyerhoff JL. Effects of social defeat and of diazepam on behavior in a resident‐intruder test in male DBA/2 mice. Pharmacology, Biochemistry and Behavior 2000;67(3):433‐47. - PubMed
Lundbeck 2003
    1. Lundbeck Institute. Psychotropics. http://www.psychotropics.dk/ 2003.
Massad 2006
    1. Massad PM, Hulsey TL. Causal attributions in posttraumatic stress disorder: implications for clinical research and practice. Psychotherapy (Chic) 2006;43(2):201‐15. - PubMed
Mayou 2000
    1. Mayou RA, Ehlers A, Hobbs M. Psychological debriefing for road traffic accident victims. Three‐year follow‐up of a randomised controlled trial. British Journal of Psychiatry 2000;176:589‐93. - PubMed
McCleery 2004
    1. McCleery JM, Harvey AG. Integration of psychological and biological approaches to trauma memory: implications for pharmacological prevention of PTSD. Journal of Traumatic Stress 2004;17(6):485‐96. - PubMed
Meewisse 2007
    1. Meewisse ML, Reitsma JB, Vries GJ, Gersons BP, Olff M. Cortisol and post‐traumatic stress disorder in adults: systematic review and meta‐analysis. British Journal of Psychiatry 2007;191:387‐92. - PubMed
Mueser 2008
    1. Mueser KT, Rosenberg SD, Xie H, Jankowski MK, Bolton EE, Lu W, et al. A randomized controlled trial of cognitive‐behavioral treatment for posttraumatic stress disorder in severe mental illness. Journal of Consulting and Clinical Psychology 2008;76(2):259‐71. - PMC - PubMed
Nicholson 2013
    1. Nicholson EL, Bryant RA, Felmingham KL. Interaction of noradrenaline and cortisol predicts negative intrusive memories in posttraumatic stress disorder. Neurobiology of Learning and Memory 2013;112:204‐11. - PubMed
Nickerson 2013
    1. Nickerson A, Aderka IM, Bryant RA, Hofmann SG. The role of attribution of trauma responsibility in posttraumatic stress disorder following motor vehicle accidents. Depression and Anxiety 2013;30(5):483‐8. - PubMed
Norris 2007
    1. Norris F, Sloane LB. The epidemiology of trauma and PTSD. In: Friedman MJ, Keane TM, Resick PA editor(s). Handbook of PTSD: Science and Practice. New York, NY: Guilford Press, 2007:78‐98.
Ozer 2003
    1. Ozer EJ, Best SR, Lipsey TL, Weiss DS. Predictors of posttraumatic stress disorder and symptoms in adults: a meta‐analysis. Psychological Bulletin 2003;129(1):52‐73. - PubMed
Peñalba 2009
    1. Peñalba V, McGuire H, Leite JR. Psychosocial interventions for prevention of psychological disorders in law enforcement officers. Cochrane Database of Systematic Reviews 2008, Issue 3. [DOI: 10.1002/14651858.CD005601.pub2] - DOI - PubMed
Pitman 1989
    1. Pitman RK. Post‐traumatic stress disorder, hormones, and memory. Biological Psychiatry 1989;26(3):221‐3. - PubMed
Pitman 2005
    1. Pitman RK, Delahanty DL. Conceptually driven pharmacologic approaches to acute trauma. CNS Spectrums 2005;10:99‐106. - PubMed
Robert 1999
    1. Robert R, Blakeney PE, Villarreal C, Rosenberg L, Meyer WJ 3rd. Imipramine treatment in pediatric burn patients with symptoms of acute stress disorder: a pilot study. Journal of the American Academy of Child & Adolescent Psychiatry 1999;38(7):873‐82. - PubMed
Robert 2008
    1. Robert R, Tcheung WJ, Rosenberg L, Rosenberg M, Mitchell C, Villarreal C, et al. Treating thermally injured children suffering symptoms of acute stress with imipramine and fluoxetine: a randomized, double‐blind study. Burns 2008;34(7):919‐28. - PubMed
Roberts 2010
    1. Roberts NP, Kitchiner NJ, Kenardy J, Bisson JI. Multiple session early psychological interventions for the prevention of post‐traumatic stress disorder. Cochrane Database of Systematic Reviews 2010, Issue 3. [DOI: 10.1002/14651858.CD006869.pub2] - DOI - PubMed
Rose 2002
    1. Rose SC, Bisson J, Churchill R, Wessely S. Psychological debriefing for preventing post traumatic stress disorder (PTSD). Cochrane Database of Systematic Reviews 2002, Issue 2. [DOI: 10.1002/14651858.CD000560] - DOI - PubMed
Ruzek 2001
    1. Ruzek J, Watson P. Early intervention to prevent PTSD and other trauma‐related problems. PTSD Research Quarterly 2001;12(4):1‐7.
Sapolsky 2000
    1. Sapolsky RM. Glucocorticoids and hippocampal atrophy in neuropsychiatric disorders. Archives of General Psychiatry 2000;57(10):925‐35. - PubMed
Schelling 1999
    1. Schelling G, Stoll C, Kapfhammer HP, Rothenhausler HB, Krauseneck T, Durst K, et al. The effect of stress doses of hydrocortisone during septic shock on posttraumatic stress disorder and health‐related quality of life in survivors. Critical Care Medicine 1999;27(12):2678‐83. - PubMed
Schnurr 2009
    1. Schnurr PP, Lunney CA, Bovin MJ, Marx BP. Posttraumatic stress disorder and quality of life: extension of findings to veterans of the wars in Iraq and Afghanistan. Clinical Psychology Review 2009;29:727‐35. - PubMed
Shalev 2006
    1. Shalev A, Freedman S, Adessky R, Watson P. Early interventions for PTSD: what works, and for whom?. 22nd Annual Meeting, International Society for Traumatic Stress Studies, November 4‐7, Hollywood, CA. 2006.
Sheehan 1996
    1. Sheehan DV, Harnett‐Sheehan K, Raj BA. The measurement of disability. International Clinical Psychopharmacology 1996;11 Suppl 3:89‐95. - PubMed
Solomon 1997
    1. Solomon SD, Davidson JR. Trauma: prevalence, impairment, service use, and cost. Journal of Clinical Psychiatry 1997;58 Suppl 5:1‐11. - PubMed
Sones 2011
    1. Sones HM, Thorp SR, Raskind M. Prevention of posttraumatic stress disorder. Psychiatric Clinics of North America 2011;34:79–94. - PubMed
Spitzer 1996
    1. Spitzer R, Williams J, Gibbons M. Instructional Manual for the Structured Clinical Interview for DSM‐IV. New York, NY: New York State Psychiatric Institute, 1996.
Sterne 2011
    1. Sterne JAC, Egger M, Moher D (editors). Chapter 10: Addressing reporting biases. In: Higgins JPT, Green S editor(s). Cochrane Handbook for Systematic Reviews of Interventions. The Cochrane Collaboration, 2011.
Thompson 1994
    1. Thompson SG. Why sources of heterogeneity in meta‐analysis should be investigated. BMJ 1994;309(6965):1351‐5. - PMC - PubMed
Turpin 2005
    1. Turpin G, Downs M, Mason S. Effectiveness of providing self‐help information following acute traumatic injury: randomised controlled trial. British Journal of Psychiatry 2005;187:76‐82. - PubMed
Van Emmerik 2008
    1. Emmerik AA, Kamphuis JH, Emmelkamp PM. Treating acute stress disorder and posttraumatic stress disorder with cognitive behavioral therapy or structured writing therapy: a randomized controlled trial. Psychotherapy and Psychosomatics 2008;77(2):93‐100. - PubMed
van Zuiden 2013
    1. Zuiden M, Kavelaars A, Geuze E, Olff M, Heijnen CJ. Predicting PTSD: pre‐existing vulnerabilities in glucocorticoid‐signaling and implications for preventive interventions. Brain, Behavior, and Immunity 2013;30:12‐21. - PubMed
Verbeke 2000
    1. Verbeke M, Molenberghs G. Linear Mixed Models for Longitudinal Data. New York, NY: Springer, 2000.
Ware 1992
    1. Ware JE, Sherbourne CD. The MOS 36‐Item Short‐Form Health Survey (SF‐36): I. Conceptual framework and item selection. Medical Care 1992;30:473‐81. - PubMed
Weathers 2001
    1. Weathers FW, Keane TM, Davidson JR. Clinician‐administered PTSD scale: a review of the first ten years of research. Depression and Anxiety 2001;13(3):132‐56. - PubMed
Weisaeth 1989
    1. Weisaeth L. Torture of a Norwegian ship's crew. The torture, stress reactions and psychiatric after‐effects. Acta Psychiatrica Scandinavica. Supplementum 1989;355:63‐72. - PubMed
WHO 1997
    1. World Health Organization. Composite International Diagnostic Interview (CIDI) 2.1. Geneva, Switzerland: World Health Organization, 1997.
Yehuda 1990
    1. Yehuda R, Southwick SM, Nussbaum G, Wahby V, Giller EL Jr, Mason JW. Low urinary cortisol excretion in patients with posttraumatic stress disorder. Journal of Nervous and Mental Disease 1990;178(6):366‐9. - PubMed
Yehuda 2006
    1. Yehuda R. Advances in understanding neuroendocrine alterations in PTSD and their therapeutic implications. Annals of the New York Academy of Sciences 2006;1071:137‐66. - PubMed
Yehuda 2008
    1. Yehuda R, Bierer LM. Transgenerational transmission of cortisol and PTSD risk. Progress in Brain Research 2008;167:121‐35. - PubMed

Publication types

MeSH terms

LinkOut - more resources