ABSTRACT

Post-traumatic stress disorder is a common condition that affects millions of people across the world. Up to date recommendations based on the best available evidence are vital to prevent and treat this debilitating condition. In this issue, we are bringing together a series of systematic reviews and meta-analyses that underpinned the development of the 2018 International Society for Traumatic Stress Studies Guidelines.

The strongest evidence was found for psychological treatments for PTSD, in particular for cognitive behavioural therapy with a trauma focus (CBT-TF)(generic), cognitive processing therapy (CPT), cognitive therapy (CT), eye movement desensitisation and reprocessing (EMDR) and prolonged exposure (PE). For the subgroup of military personnel and veterans, results were less impressive. Dropout from trauma-focused psychological treatments was higher than for other forms of psychological treatment for PTSD in adults. For early interventions, CBT-TF, CT and EMDR were recommended. With regard to pharmacological approaches, a number of them were effective but with a low effect size. Of the pharmacologically assisted psychotherapies, MDMA-assisted psychotherapy was promising. Six complementary and alternative approaches showed emerging evidence.

We now have an evidence base for a diverse range of pharmacological, psychological and other approaches that should facilitate their implementation and lead to the more effective management of people affected by traumatic events.

摘要

创伤后应激障碍是一种影响全世界数百万人的常见疾病。基于现有最佳证据的最新建议对于预防和治疗这种使人衰弱的疾病至关重要。在本期中，我们汇集了一系列系统评价和荟萃分析，这些系统评价和荟萃分析为 2018 年国际创伤应激研究学会指南的制定提供了基础。

最有力的证据是针对 PTSD 的心理治疗，特别是针对创伤焦点的认知行为疗法 (CBT-TF)（通用）、认知加工疗法 (CPT)、认知疗法 (CT)、眼球运动脱敏和再加工 (EMDR) ) 和长时间暴露 (PE)。对于军事人员和退伍军人的亚组，结果不那么令人印象深刻。成人创伤后应激障碍心理治疗的辍学率高于其他形式的心理治疗。对于早期干预，推荐使用 CBT-TF、CT 和 EMDR。关于药理学方法，其中一些是有效的，但效果较小。在药物辅助心理治疗中，MDMA 辅助心理治疗很有前景。六种补充和替代方法显示了新的证据。

我们现在拥有各种药理学、心理学和其他方法的证据基础，这些方法应该有助于它们的实施，并导致对受创伤事件影响的人进行更有效的管理。