The role of psychological support interventions in trauma patients on mental health outcomes: A systematic review and meta-analysis

Abstract

BACKGROUND The recovery and rehabilitation of trauma survivors may be long and challenging. Patients may be prone to psychiatric disorders, cognitive impairments, and decreased quality of life. The objective of this review was to determine whether there is a role for psychological interventions in reducing the incidence and severity of psychiatric sequelae in trauma survivors. METHODS MEDLINE, PubMed, SCOPUS, and Google Scholar were searched for published articles. We searched for articles published between 1990 and 2018 with adult subjects, and limited our search to articles published in English. Randomized controlled trials that evaluated various psychiatric interventions in trauma patients on the effects of psychiatric outcomes were included for analysis. The articles were independently reviewed for eligibility by two different reviewers. A meta-analysis was performed on nine studies with similar interventions, outcomes measured, and patient populations. RESULTS Nine hundred thirty-four articles were identified [830 articles identified through database search, and 107 through article references]. Sixty-nine full-text articles were reviewed for eligibility. Of these, 33 were included for qualitative analysis. Thirteen studies evaluating the effect of cognitive behavioral therapy (CBT)-based interventions on the severity of posttraumatic stress disorder (PTSD), anxiety, and depression symptoms underwent meta-analysis. While CBT-treated patients experienced clinically significant decreases in symptom severity, there were no statistically significant differences between treatment and control groups at follow-up for PTSD, anxiety, and depression. CONCLUSION Compared with usual care, CBT-based interventions may not be effective in decreasing or preventing PTSD, anxiety, or depression symptoms in trauma survivors. LEVEL OF EVIDENCE Systematic Review, level III.

Systematic review and meta‐analyses of randomized control trials of the effectiveness of psychosocial interventions for homeless adults

“…The subgroup meta‐analyses show that there were no significant effects of CBT on depression and anxiety. Our finding is consistent with a previous study, which reported that CBT for patients who experienced trauma did not reduce depression and anxiety significantly (Pham et al, ). In contrast, another study reported that CBT reduced depression significantly for the people with HIV and depression (Shi et al, ) and CBT has been suggested as an efficacious therapy in PTSD management (Cusack et al, ).…”

“…In contrast, another study reported that CBT reduced depression significantly for the people with HIV and depression (Shi et al, 2019) and CBT has been suggested as an efficacious therapy in PTSD management (Cusack et al, 2016). The inconsistent results of the previous research may be due to the differences in selected study participants (Pham et al, 2019), variability in the number of sessions and follow-up times (Kline, Cooper, Rytwinksi, & Feeny, 2018). Therefore, additional research should be conducted to verify the effectiveness of CBT for the homeless persons.…”

Beyond pain and disability: The lasting effects of trauma on life after injury

“…Postinjury interventions might include informational and peer support, 36 or mental health initiatives to help decrease rates of PTSD, anxiety, and depression going forward, particularly in high-risk patients 37 . There is relatively sparse evidence in this realm, and a recent meta-analysis found no decrease in these disorders in trauma patients treated with cognitive behavioral theory-base interventions 38 . Certainly, further research into potential effective interventions is warranted.…”

Psychological and psychosocial aspects of major trauma care: A survey of current practice across UK and Ireland

“…It is not clear why this model was not incorporated into subsequent major trauma policy documents and guidance. However, there is increasing evidence of effectiveness of stepped psychological and psychosocial approaches in major trauma care in terms of improving longer term outcomes 41 , reducing posttraumatic psychological distress symptoms and identifying those at risk of developing PTSD, anxiety and/or depression 41,42 .…”