Early interventions for the prevention of PTSD in adults: a systematic literature review

Abstract Background Secondary interventions are implemented within a short interval following the occurrence of traumatic events with the purpose of preventing the onset of PTSD. Objective Analyze the results of studies that assessed post-trauma interventions in adults aimed at preventing the onset of PTSD or symptoms related to PTSD. Methods We performed literature searches using the search expression [(Early intervention OR secondary prevention) AND (Post traumatic stress disorder OR PTSD)] for articles published until October 2016. Among the references found, 29 fulfilled the selection criteria established for the review. Data were divided and analyzed according to the type of intervention: pharmacological or psychological. Results Psychological measures used in the studies lack homogeneity regarding the type of intervention and the assessment of intervention outcomes. Pharmacological interventions were less frequent and findings require replication, together with an expansion in the types of substances investigated. In general, many of the studies reviewed suggest that both pharmacological and psychological interventions are effective in the prevention of PTSD. Discussion Future trials should be focused on determining the best interventions for the secondary prevention of PTSD. The combination of psychological and pharmacological interventions for post-trauma patients poses opportunities and challenges that remain unexplored.

背景：创伤事件发生后短期内即实施二级干预，旨在预防创伤后应激障碍（Post Traumatic Stress Disorder，以下简称PTSD）的发生。研究目的：分析针对成人开展的创伤后干预相关研究结果，这类干预以预防PTSD发生或缓解相关症状为目标。研究方法：本研究以[(早期干预 OR 二级预防) AND (创伤后应激障碍 OR PTSD)]为检索式，检索了2016年10月之前发表的相关文献。最终纳入符合本综述既定筛选标准的29篇参考文献，并依据干预类型（药物干预或心理干预）对数据进行分类与分析。研究结果：本次综述纳入的研究中，心理干预措施在干预类型与干预效果评估维度上均缺乏同质化标准。药物干预相关研究占比较少，现有研究结论尚需重复验证，且需拓展所调研的药物品类范围。总体而言，纳入综述的多项研究均表明，药物干预与心理干预均对PTSD的预防具有有效性。讨论：未来的临床试验应聚焦于探索适用于PTSD二级预防的最优干预方案。针对创伤后患者联合实施心理与药物干预的模式，既存在潜在发展机遇，也面临诸多尚未被探索的挑战。