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Suggested Citation:"Appendix B: Search Strategy." Institute of Medicine. 2008. Treatment of Posttraumatic Stress Disorder: An Assessment of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/11955.
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Page 165
Suggested Citation:"Appendix B: Search Strategy." Institute of Medicine. 2008. Treatment of Posttraumatic Stress Disorder: An Assessment of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/11955.
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Page 166
Suggested Citation:"Appendix B: Search Strategy." Institute of Medicine. 2008. Treatment of Posttraumatic Stress Disorder: An Assessment of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/11955.
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Page 167
Suggested Citation:"Appendix B: Search Strategy." Institute of Medicine. 2008. Treatment of Posttraumatic Stress Disorder: An Assessment of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/11955.
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Page 168

Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

Appendix B Search Strategy Search 1—Meta-analyses or reviews ((Anxiety Disorders) OR PTSD) AND Veterans AND Drug therapies AND (Meta-analyses OR Reviews) Search 2—Meta-analyses or reviews (((Anxiety Disorders) OR PTSD) AND Veterans AND Psychotherapies AND (Meta-analyses OR Reviews)) Search 3—Clinical trials or epidemiological studies ((Anxiety Disorders) OR PTSD) AND Veterans AND Drug therapies AND (Clinical trials OR Epidemiological Studies) Search 4—Clinical trials or epidemiological studies ((Anxiety Disorders) OR PTSD) AND Veterans AND Psychotherapies AND (Clinical trials OR Epidemiological Studies) Search 5—Studies other than meta-analyses, reviews, clinical trials or epi- demiological studies (((Anxiety Disorders) OR PTSD) AND Veterans AND Drug therapies) NOT (Results from Search 1 OR Search 3) Search 6—Studies other than meta-analyses, reviews, clinical trials or epi- demiological studies (((Anxiety Disorders) OR PTSD) AND Veterans AND Psychotherapies) NOT (Results from Search 2 OR Search 4) 165

166 TREATMENT OF POSTTRAUMATIC STRESS DISORDER Search 7—Treatment outcomes, prognosis, disease progression or recovery ((Anxiety Disorders) OR PTSD) AND Veterans AND (Treatment Outcomes) Detailed Description of Each Set Employed in the Searches Outlined Above All databases were searched via the OVID database gateway. OVID com- mand-line syntax: • Exp [explode] – automatically includes all narrower subject head- ing from the thesaurus or controlled vocabulary for any given database • Forward slash [/] – forces OVID to search in the subject headings or controlled vocabulary • Adj – adjacency or proximity operator • Pt=publication type; ti=title; ab=abstract ; sh=subject ­ heading ; fs=floating sub-heading ; dt=drug therapy sub-­heading ; th=therapeutic interventions other than drug therapies, subheading Anxiety Disorders and Traumatic Stress Disorders Set (exp Anxiety Disorder?/ or (anxiety disorder? or post-traumatic stress or posttraumatic stress or PTSD).ti,ab. or combat experience/)) [NOTE: ex- ploding (exp) Anxiety Disorders automatically includes all types of Trau- matic Stress Disorders to include PTSD] Veterans or Military Set (veteran? or veterans, hospitals/ or military medicine/ or military psychia- try/ or military personnel/ or exp War/ OR World War I/ or World War II/ or Korean War/ or vietnam conflict/ or Gulf War/ OR (army or navy or air force or marines or soldier) veterans/ or exp military phenomena/ or soldier/ or battle injury/) Drug Therapies or Pharmacotherapies Set (exp drug therapy/ or (drug therap$ or pharmacotherap$).ti,ab. or exp serotonin uptake inhibitors/ or exp serotonin agents/ or (selective serotonin reuptake inhibitors or SSRI?) OR exp Monoamine Oxidase Inhibitors/ OR MAOI? OR exp Antidepressive Agents, Tricyclic/ OR ((TCA? and anti- depress$) or anti depress$) OR exp Stress Disorders, Traumatic/dt or exp

APPENDIX B 167 Anxiety Disorders/dt OR (exp stress disorders, traumatic/ and dt.fs.) OR (exp Anxiety Disorders/ and dt.fs.) OR exp adrenergic antagonists/ OR exp adrenergic uptake inhibitors/ OR Guanfacine/ OR guanfacine.ti,ab. OR exp anti-anxiety agents/ or exp antipsychotic agents/ OR exp Anticonvulsants/ OR exp Serotonin Reuptake Inhibitors/ or exp Tricyclic Antidepressant Drugs/ or Adrenergic Blocking Drugs/ or exp neuroleptic Drugs/ or exp Anticonvulsive Drugs/) Psychotherapies Set (exp psychotherapy/ or psychotherap$.ti,ab. OR exp Stress Disorders, ������������������������� Traumatic/th or exp Anxiety Disorders/th OR (exp stress disorders, trau- matic/ and th.fs.) or (exp Anxiety Disorders/ and th.fs.) OR exp Behavior Therapy/ OR (cognit$ behav$ therapy or exposure therapy or cognitive processing therapy or «biofeedback and relaxation training» or systematic desensitization or assertiveness training or stress innoculation training) OR psychodynamic psychotherapy OR («eye movement desensitization and reprocessing» or EMDR) OR social rehabilitat$ therap$ OR exp psycho- therapy, group/ OR family therapy/ or marital therapy/) Reviews and Meta-Analyses Set (systematic review$.ti,ab,sh,pt. OR systematic literature review$.ti,ab,sh. OR meta-analysis.pt,ti,ab,sh. or (meta-analy$ or metaanaly$).ti,ab,sh. OR ((methodol$ OR systematic$ or quantitativ$) adj3 (review$ or overview$ or survey$)).ti,ab,sh. OR (Medline or Embase or Index Medicus).ti,ab,sh. OR ((pool$ or combined or combining) adj (data or trials or studies or results)).ti,ab. OR review literature/ or review.pt,sh.) Clinical Trials or Epidemiological Studies Set ((randomized controlled trial or controlled trial).pt. OR randomized con- trolled trials/ or controlled clinical trials/ OR random$.ti,ab. or Double- blind method/ or Random allocation/ OR single blind method/ OR ((singl$ or doubl$ or trebl$ or tripl$) adj (blind$ or mask$)) OR clinical trial.pt. OR clinical trials/ OR (clinical adj trial$).ti,ab. OR placebos/ OR placebo$. ti,ab. OR research design/ OR Comparative Study/ or comparative stud$. ti,ab. OR exp evaluation studies/ or follow-up studies/ or follow up.ti,ab. or prospective studies/ OR (control$ or prospectiv$ or volunteer$).ti,ab.)

168 TREATMENT OF POSTTRAUMATIC STRESS DISORDER Prognosis, Recovery, Rehabilitation Set (disease progression/ OR prognosis/ or disease-free survival/ or medical futility/ or exp treatment outcome/ or treatment failure/ OR (recovery or rehabilitat$).ti,ab. or rehabilitation/ OR “recovery (disorders)”/)

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Mental disorders, including posttraumatic stress disorder (PTSD), constitute an important health care need of veterans, especially those recently separated from service. Treatment of Posttraumatic Stress Disorder: An Assessment of the Evidence takes a systematic look the efficacy of pharmacologic and psychological treatment modalities for PTSD on behalf of the Department of Veterans Affairs. By reviewing existing studies in order to draw conclusions about the strength of evidence on several types of treatment, the Committee on the Treatment of Posttraumatic Stress Disorder found that many of these studies were faulty in design and performance, and that relatively few of these studies have been conducted in populations of veterans, despite suggestions that civilian and veteran populations respond differently to various types of treatment. The committee also notes that the evidence is scarce on the acceptability, efficacy, or generalizability of treatment in ethnic and cultural minorities, as few studies stratified results by ethnic background.

Despite challenges in the consistency, quality, and depth of research, the committee found the evidence sufficient to conclude the efficacy of exposure therapies in treating PTSD. The committee found the evidence inadequate to determine efficacy of different types of pharmacotherapies, of three different psychotherapy modalities, and of psychotherapy delivered in group formats. The committee also made eight critical recommendations, some in response to the VA's questions related to recovery and the length and timing of PTSD treatment, and others addressing research methodology, gaps in evidence and funding issues.

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