CBT most effective for children with post-traumatic stress disorder

Dec 13 2012

By Helen Albert, Senior medwireNews Reporter

Research published in The Cochrane Database of Systematic Reviews confirms the effectiveness of psychologic therapy for children with post-traumatic stress disorder (PTSD), particularly cognitive behavioral therapy (CBT).

"There is fair evidence for the effectiveness of psychological therapies, particularly CBT, in treating post-traumatic stress disorder in children," said lead researcher Donna Gillies (Cumberland Hospital, Parramatta, Australia) in a press statement.

"However, more effort needs to be devoted to increasing follow-up in children so we can understand whether these therapies are making a difference in the long-term," she added.

Gillies and colleagues carried out a systematic review of 14 studies, which included 758 children with PTSD, aged 3-18 years, who had been exposed to sexual abuse, civil violence, natural disaster, domestic violence, and motor vehicle accidents, to assess the benefits of psychologic therapy.

The therapies assessed in the studies included CBT, exposure-based, psychodynamic, narrative, supportive counseling, and eye movement desensitization and reprocessing (EMDR), and most studies compared a psychologic therapy with a control group.

When all participants and therapies were pooled, improvement (reduction in the number of patients still classified as having PTSD) was over four times better, and symptoms of PTSD, anxiety, and depression were significantly lower in those undergoing psychologic therapy compared with controls within 1 month of completing therapy.

When the different types of therapy were assessed separately, CBT produced the best results with a reduction in number of PTSD diagnoses of over eightfold in CBT treated individuals than in controls within 1 year of completing treatment. PTSD symptom score also remained significantly lower with CBT than control therapy within 1 year, and depression scores were significantly lower for up to 1 month with CBT versus control.

"More trials comparing the various psychological therapies are required to find out whether specific psychological therapies are more effective for the treatment of PTSD in children and adolescents," said Gillies.

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