期刊
CLINICAL PSYCHOLOGY REVIEW
卷 38, 期 -, 页码 25-38出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.cpr.2015.02.007
关键词
Posttraumatic stress disorder; Substance use disorder; Comorbidity; Psychological intervention; Meta-analysis
资金
- National Institute of Social Care and Health Research - Academic Health Science Committee (NISCHR AHSC)
- Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine
- Cardiff & Vale University Health Board
Co-morbid post-traumatic stress disorder (PTSD) and substance use disorder (SUD) are common, difficult to treat, and associated with poor prognosis. This review aimed to determine the efficacy of individual and group psychological interventions aimed at treating comorbid PTSD and SUD, based on evidence from randomised controlled trials. Our pre-specified primary outcomes were PTSD severity, drug/alcohol use, and treatment completion. We undertook a comprehensive search strategy. Included studies were rated for methodological quality. Available evidence was judged through GRADE. Fourteen studies were included. We found that individual trauma-focused cognitive-behavioural intervention, delivered alongside SUD intervention, was more effective than treatment as usual (TAU)/minimal intervention for PTSD severity post-treatment, and at subsequent follow-up. There was no evidence of an effect for level of drug/alcohol use post-treatment but there was an effect at 5-7 months. Fewer participants completed trauma-focused intervention than TAU. We found little evidence to support the use of individual or group-based non-trauma-focused interventions. All findings were judged as being of low/very low quality. We concluded that there is evidence that individual trauma-focused psychological intervention delivered alongside SUD intervention can reduce PTSD severity, and drug/alcohol use. There is very little evidence to support use of non-trauma-focused individual or group-based interventions. (C) 2015 Elsevier Ltd. All rights reserved.
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