Meinhausen Corinne, Fu Katherine, Urbina Richard D, Gunby Tanisha, Perez Lauren A, Wilson Patrick A, Luberto Christina M, Sumner Jennifer A
Department of Psychology, University of California, Los Angeles, CA, USA.
Edson College of Nursing and Health Innovation, Arizona State University, Tempe, AZ, USA.
Health Psychol Rev. 2025 Jul 16:1-19. doi: 10.1080/17437199.2025.2526666.
Serious medical events are increasingly recognised as potential triggers for posttraumatic stress disorder (PTSD). This systematic review evaluated the efficacy of interventions for medically induced PTSD. Nine electronic databases were searched from inception to November 2023 (PROSPERO ID: CRD42024504055). Eligible studies were randomised controlled trials of interventions for adults diagnosed with, or exhibiting elevated symptoms of, PTSD related to life-threatening medical events. Risk of bias (RoB) was assessed using the Cochrane RoB 2 tool. Group differences at follow-up were assessed using independent -tests for statistical significance, and Cohen's was calculated to measure effect sizes. Eleven trials (sample sizes: 17-89) met inclusion criteria, with PTSD primarily resulting from cardiovascular events ( = 5) or cancer ( = 4). Interventions included trauma-focused psychotherapies ( = 8; e.g., Eye Movement Desensitisation and Reprocessing [EMDR]) and others ( = 3; e.g., supportive therapy). Most studies reported significant posttreatment differences and large effect sizes favouring the intervention group, with EMDR and other trauma-focused psychotherapies particularly well-supported. Common limitations included small sample sizes, use of self-reported outcomes, and high dropout rates. Results highlight the efficacy of several interventions for medically induced PTSD and the need for larger trials.
严重医疗事件日益被视为创伤后应激障碍（PTSD）的潜在触发因素。本系统评价评估了针对医源性PTSD的干预措施的疗效。检索了9个电子数据库，检索时间从建库至2023年11月（PROSPERO注册号：CRD42024504055）。符合条件的研究为针对被诊断患有与危及生命的医疗事件相关的PTSD或表现出PTSD症状加重的成年人的干预措施的随机对照试验。使用Cochrane偏倚风险2工具评估偏倚风险（RoB）。随访时的组间差异采用独立t检验评估统计学显著性，并计算科恩d值以测量效应大小。11项试验（样本量：17 - 89）符合纳入标准，PTSD主要由心血管事件（n = 5）或癌症（n = 4）引起。干预措施包括以创伤为重点的心理治疗（n = 8；例如，眼动脱敏再处理疗法[EMDR]）和其他疗法（n = 3；例如，支持性治疗）。大多数研究报告了治疗后有显著差异，且效应大小有利于干预组，其中EMDR和其他以创伤为重点的心理治疗得到了特别有力的支持。常见的局限性包括样本量小、使用自我报告的结果以及高失访率。结果突出了几种针对医源性PTSD的干预措施的疗效以及进行更大规模试验的必要性。
