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Meta-Analysis
. 2022 Aug 24;17(8):e0272732.
doi: 10.1371/journal.pone.0272732. eCollection 2022.

The effectiveness of psychological interventions for reducing PTSD and psychological distress in first responders: A systematic review and meta-analysis

Khalid M Alshahrani  1   2 , Judith Johnson  1   3   4 , Arianna Prudenzi  5 , Daryl B O'Connor  1
Affiliations
Meta-Analysis

The effectiveness of psychological interventions for reducing PTSD and psychological distress in first responders: A systematic review and meta-analysis

Khalid M Alshahrani et al. PLoS One. .

Abstract

Background: First responders are faced with stressful and traumatic events in their work that may affect their psychological health. The current review examined the effectiveness of psychological interventions to treat posttraumatic stress disorder (PTSD), anxiety, depression, stress and burnout in first responders.

Methods: Four databases were searched to identify controlled studies that examined the efficacy of psychological interventions to reduce PTSD symptoms (primary outcome) in first responders (including firefighters, police/law enforcement officers, search and rescue personnel, emergency and paramedics teams). Secondary outcomes were anxiety, depression, burnout, and stress.

Results: 15 studies were identified, including 10 studies that measured PTSD, 7 studies for anxiety, 10 studies for depression, 7 studies for stress and 1 for burnout. Interventions were associated with a significant reduction in PTSD (SDM = -0.86; 95% CI = -1.34 -- 0.39), depression (SDM = -0.63; 95% CI = -0.94 --0.32), and anxiety (SDM = -0.38; 95% CI = -0.71 --0.05) but not stress (SDM = -0.13; 95% CI = -0.51-0.25). CBT-based and clinician-delivered interventions were associated with significantly greater reductions in PTSD than other types of interventions and non-clinician interventions, but no differences were found for depression. There was evidence of moderate to high risk of bias across all studies.

Conclusions: Psychological interventions are effective in reducing PTSD, depression and anxiety symptoms but not stress in first responders. Further research is needed using high quality randomised designs over longer periods of follow-up.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram of article selection.
aSome studies were excluded for more than one reason so the total studies do not equal 66.
Fig 2
Fig 2. Forest plot for the effect of interventions on PTSD symptoms.
Fig 3
Fig 3. Forest plot for the effect of interventions on depression symptoms.
Fig 4
Fig 4. Forest plot for the effect of interventions on anxiety symptoms.
Fig 5
Fig 5. Forest plot for the effect of interventions on stress symptoms.
See this image and copyright information in PMC

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