The following HTML text is provided to enhance online
readability. Many aspects of typography translate only awkwardly to HTML.
Please use the page image
as the authoritative form to ensure accuracy.
Treatment of Posttraumatic Stress Disorder: An Assessment of the Evidence
Evidence is suggestive but not sufficient to conclude the efficacy of X in the treatment of PTSD. (The committee may note inconsistencies in the data.)
Evidence is inadequate to determine the efficacy of X in the treatment of PTSD.
Evidence is suggestive that X treatment is ineffective in treating PTSD.
Evidence is suggestive that X treatment is harmful in the treatment of PTSD.
For each of the conclusions above, the restriction of the conclusion regarding the population, provider, setting [of] intervention, or comparator intervention will be noted.
As part of its assessment, the IOM committee shall note limitations in the evidence base and make suggestions for further research that could strengthen the evidence or address research gaps in the treatment of PTSD.
In conducting its work, the committee shall consider the following questions in relation to treatment modalities (including pharmacotherapy and psychotherapy) and treatment goals for individuals diagnosed with PTSD.
What are the goals of PTSD treatment?
What is the definition of recovery?
For what proportion of patients is recovery possible?
Besides recovery, what other outcomes would benefit patients?
Does evidence support the value of early intervention?
How long should treatment continue?
What is the impact of a hiatus in treatment?
What is the impact of periodic reexamination for asymptomatic patients?
The committee shall note when the evidence base does not allow for responding to these questions due to insufficient research attention or poorly conducted studies.
nonrandomized and uncontrolled studies for several reasons. It is extremely difficult to answer questions of efficacy in an uncontrolled way because of the variability of treatments, outcome measures, disease course, and patient choice. RCTs are the most reliable form of evidence for efficacy, and the committee found that the characteristics of the disorder, its measurement, and its treatment are sufficiently heterogeneous that observational studies were unlikely to provide useful evidence beyond the data available from RCTs. Therefore, per part II.B of the Statement of Task, all studies included in this review are classified as level I evidence.