Evaluation of the efficacy of pharmacotherapy and psychotherapy in treatment of combat-related post-traumatic stress disorder: a meta-analytic review of outcome studies

• Published in: Military medicine 2009-05, Vol.174 (5), p.460-469
• Main Authors: Stewart, Cheryl L, Wrobel, Thomas A
• Format: Article
• Language: English
• Subjects: Antidepressive Agents - therapeutic use; Combat Disorders - drug therapy; Combat Disorders - therapy; Depression - drug therapy; Depression - therapy; Humans; Military Personnel - psychology; Military Psychiatry - methods; Outcome Assessment (Health Care); Psychotherapy - methods; Systematic review
• ISSN: 0026-4075; 1930-613X
• DOI: 10.7205/MILMED-D-04-1507

A meta-analysis was conducted to examine the relative effectiveness of the broad-based treatments for combat-related post-traumatic stress disorder (PTSD). The analysis includes 13 pharmacotherapy studies and 12 psychotherapy studies obtained from a PsychINFO database search and a reference search. Studies of pharmacotherapy treatment efficacy demonstrated a significantly greater decrease in reducing PTSD symptoms, t (22) = -2.74, p = 0.01, d = 0.05. A random coefficient analysis supports this finding with significance determined at p < 0.001 for the fixed effects in the models. A limited examination of depression as a frequently comorbid disorder indicated pharmacotherapy also demonstrated a significantly greater decrease than psychotherapy in depression symptoms, t (15.77) = -2.26, p = 0.04, d = 0.16. Differences between treatments are discussed as potentially reflective of assignment to treatments and assessment techniques as well as therapeutic effects.