Oosterbaan Veerle, Covers Milou L V, Bicanic Iva A E, Huntjens Rafaële J C, de Jongh Ad
National Psychotrauma Center for Children and Youth, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Experimental Psychotherapy & Psychopathology, University of Groningen, Groningen, The Netherlands.
Eur J Psychotraumatol. 2019 Nov 8;10(1):1682932. doi: 10.1080/20008198.2019.1682932. eCollection 2019.
: To review the safety and efficacy of early interventions after sexual assault in reducing or preventing posttraumatic stress disorder (PTSD). : Systematic searches were performed on studies (1980-2018) that examined the efficacy of interventions for PTSD within 3 months after sexual assault. : The review identified 7 studies (n = 350) with high risk of bias that investigated 5 interventions. Only two studies reported on safety. Contact with the authors of six studies provided no indications for the occurrence of adverse events. Two studies reported the efficacy using PTSD diagnosis as dependent variable but found no difference between groups. All studies reported on efficacy using PTSD severity as dependent variable. For the meta-analysis, 4 studies (n = 293) were included yielding significantly greater reductions of PTSD severity than standard care at 2 to 12 months follow-up ( = -0.23, 95% CI [-0.46, 0.00]), but not at 1 to 6 weeks post-intervention ( = -0.28, 95% CI [-0.57, 0.02]). The heterogeneity of the interventions precluded further analyses. : Findings suggest that early interventions can lead to durable effects on PTSD severity after sexual assault. However, due to limited availability of data, it is impossible to draw definite conclusions about safety and efficacy of early interventions, and their potential to prevent PTSD.
回顾性侵犯后早期干预在减少或预防创伤后应激障碍（PTSD）方面的安全性和有效性。对1980 - 2018年期间研究性侵犯后3个月内PTSD干预效果的研究进行系统检索。该综述确定了7项存在高偏倚风险的研究（n = 350），这些研究调查了5种干预措施。仅有两项研究报告了安全性。与6项研究的作者联系未发现不良事件发生的迹象。两项研究将PTSD诊断作为因变量报告了疗效，但未发现组间差异。所有研究均将PTSD严重程度作为因变量报告了疗效。纳入荟萃分析的4项研究（n = 293）显示，在2至12个月的随访中，PTSD严重程度的降低幅度显著大于标准护理（ = -0.23，95% CI [-0.46, 0.00]），但在干预后1至6周时并非如此（ = -0.28，95% CI [-0.57, 0.02]）。干预措施的异质性妨碍了进一步分析。研究结果表明，早期干预可对性侵犯后的PTSD严重程度产生持久影响。然而，由于数据有限，无法就早期干预的安全性和有效性及其预防PTSD的潜力得出明确结论。
