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

Abstract

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. Reprint & Copyright © by Association of Military Surgeons of U.S., 2009.