Treatment Guidelines for PTSD: A Systematic Review.
Treatment Guidelines for PTSD: A Systematic Review.
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DOI：
10.3390/jcm10184175
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发表时间：
2021-09-15
影响因子：
3.9
通讯作者：
Christenson JK
中科院分区：
文献类型：
--
作者：
Martin A;Naunton M;Kosari S;Peterson G;Thomas J;Christenson JK
背景资料：本综述的目的是评估创伤后应激障碍（PTSD）的国际治疗指南的质量，并确定指南建议之间的差异，重点是治疗噩梦。研究方法：通过MEDLINE、CINAHL、PubMed、Embase和Science Direct的电子检索，以及基于网络的国际指南库检索、精神病组织网站和针对各大洲三个人口最多的英语国家的指南的网络检索，确定了指南。提取了与建议有关的数据，并采用AGREE II标准进行质量评估。结果：2004-2020年间发布的14项指南被确定纳入本次审查。只有5个不到5岁。三个准则得分很高，在所有AGREE II领域，而其他领域之间的变化。大多数指南认为心理和药物治疗是PTSD的一线治疗。除了一个指南外，所有指南都推荐认知行为疗法（CBT）作为一线心理治疗，选择性5-羟色胺再摄取抑制剂（SSRIs）作为一线药物治疗。大多数指南都没有提到将噩梦作为PTSD的一种症状进行有针对性的治疗。哌唑嗪在几个治疗噩梦的指南中进行了讨论，但建议差异很大。大多数创伤后应激障碍指南被认为是高质量的;然而，许多可以被认为是过时的。对于核心PTSD症状的建议在指南之间没有很大差异。然而，尽管有针对性的治疗噩梦的可用性，大多数指南没有充分解决这个问题。结论：指南需要保持最新，以保持临床实用性。最需要改进的是AGREE II的“适用性”、“开发的严谨性”和“利益攸关方的参与”等关键领域。由于噩梦的治疗抵抗性，指南制定小组应该考虑为他们的靶向治疗提供更详细的建议。还需要更多高质量的试验来为PTSD噩梦管理的临床建议提供坚实的基础。
Background: The aim of this review was to assess the quality of international treatment guidelines for post-traumatic stress disorder (PTSD), and identify differences between guideline recommendations, with a focus on the treatment of nightmares. Methods: Guidelines were identified through electronic searches of MEDLINE, CINAHL, PubMed, Embase and Science Direct, as well as web-based searches of international guideline repositories, websites of psychiatric organisations and targeted web-searches for guidelines from the three most populous English-speaking countries in each continent. Data in relation to recommendations were extracted and the AGREE II criteria were applied to assess for quality. Results: Fourteen guidelines, published between 2004–2020, were identified for inclusion in this review. Only five were less than 5 years old. Three guidelines scored highly across all AGREE II domains, while others varied between domains. Most guidelines consider both psychological and pharmacological therapies as first-line in PTSD. All but one guideline recommended cognitive behavioural therapy (CBT) as first-line psychological treatment, and selective serotonin reuptake inhibitors (SSRIs) as first-line pharmacological treatment. Most guidelines do not mention the targeted treatment of nightmares as a symptom of PTSD. Prazosin is discussed in several guidelines for the treatment of nightmares, but recommendations vary widely. Most PTSD guidelines were deemed to be of good quality; however, many could be considered out of date. Recommendations for core PTSD symptoms do not differ greatly between guidelines. However, despite the availability of targeted treatments for nightmares, most guidelines do not adequately address this. Conclusions: Guidelines need to be kept current to maintain clinical utility. Improvements are most needed in the AGREE II key domains of ‘applicability’, ‘rigour of development’ and ‘stakeholder involvement’. Due to the treatment-resistant nature of nightmares, guideline development groups should consider producing more detailed recommendations for their targeted treatment. More high-quality trials are also required to provide a solid foundation for making these clinical recommendations for the management of nightmares in PTSD.
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影响因子：
3.7
作者：
Giacco D;Matanov A;Priebe S
通讯作者：
Priebe S
DOI：
10.1111/j.1463-1318.2011.02765.x
发表时间：
2012-02
期刊：
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
影响因子：
--
作者：
Edwards MS;Chadda SD;Zhao Z;Barber BL;Sykes DP
通讯作者：
Sykes DP
影响因子：
1
作者：
Khazaie H;Nasouri M;Ghadami MR
通讯作者：
Ghadami MR
影响因子：
3.9
作者：
Detweiler, Mark B.;Pagadala, Bhuvaneshwar;Lutgens, BrianW.
通讯作者：
Lutgens, BrianW.
影响因子：
10.5
作者：
Gaebel, W;Weinmann, S;McIntyre, JS
通讯作者：
McIntyre, JS