Dropout from psychological therapies for post-traumatic stress disorder (PTSD) in adults: systematic review and meta-analysis.

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Autor/Urheber	Catrin Lewis; Neil P. Roberts; Samuel Gibson; Jonathan I. Bisson
Institution	Taylor & Francis Group
Titel	Dropout from psychological therapies for post-traumatic stress disorder (PTSD) in adults: systematic review and meta-analysis.
Quelle	In: 2000-8066; doi:10.1080/20008198.2019.1709709; European Journal of Psychotraumatology, Vol 11, Iss 1 (2020)(2020) PDF als Volltext kostenfreie Datei
Sprache	englisch
Dokumenttyp	online; Zeitschriftenaufsatz
DOI	10.1080/20008198.2019.1709709
Schlagwörter	post-traumatic stress disorder; trauma; psychological; therapy; dropout; review; Psychiatry
Abstract	Background: Despite the established efficacy of psychological therapies for post-traumatic stress disorder (PTSD) there has been little systematic exploration of dropout rates. Objective: To ascertain rates of dropout across different modalities of psychological therapy for PTSD and to explore potential sources of heterogeneity. Method: A systematic review of dropout rates from randomized controlled trials (RCTs) of psychological therapies was conducted. The pooled rate of dropout from psychological therapies was estimated and reasons for heterogeneity explored using meta-regression. Results:: The pooled rate of dropout from RCTs of psychological therapies for PTSD was 16% (95% CI 14–18%). There was evidence of substantial heterogeneity across studies. We found evidence that psychological therapies with a trauma-focus were significantly associated with greater dropout. There was no evidence of greater dropout from therapies delivered in a group format; from studies that recruited participants from clinical services rather than via advertisements; that included only military personnel/veterans; that were limited to participants traumatized by sexual traumas; that included a higher proportion of female participants; or from studies with a lower proportion of participants who were university educated. Conclusions: Dropout rates from recommended psychological therapies for PTSD are high and this appears to be particularly true of interventions with a trauma focus. There is a need to further explore the reasons for dropout and to look at ways of increasing treatment retention.
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