Psychological Interventions for Healthcare Providers With PTSD in Life-Threatening Pandemic: Systematic Review and Meta-Analysis

Abstract

Objective: This study aims to evaluate the effect of psychological interventions on healthcare providers (HCP) with post-traumatic stress disorder (PTSD) due to their necessary exposure in life-threatening pandemic. Methods: We performed a systematic research on Medline, Embase, Cochrane Central, PsycInfo, Cochrane Central Register of Controlled Trials, Clinicaltrials.gov, ProQuest PTSD Pubs ProQuest Dissertations & Theses Global, and other gray databases by January 2021. Randomized controlled trials involving therapeutic interventions for HCP with PTSD were included. The primary outcome was PTSD symptom severity. Summary standardized mean differences (SMDs) and 95% confidence intervals were estimated using inverse variance meta-analysis with fixed effects. Risks of bias were assessed using Cochrane methods. Results: Among 773 citations, this review includes six studies, randomizing 810 participants. A meta-analysis of the effect of interventions compared to placebo showed a significant reduction of PTSD symptom severity: Cognitive Behavioral Therapy-Brief (CBT-B) (M = 27.80, 95% CI: 17.12, 38.48), Cognitive Behavioral Therapy-Long (CBT-L) (M = 26.50, 95% CI: 15.75, 37.25), and Mindfulness-Based Stretching and Deep Breathing Exercise (MBX) (M = 17.2, 95% CI: 6.57, 27.83). CBT-L and CBT-B also showed a significant effect on depression severity. Conclusions: The most effective and feasible treatment option for HCP with PTSD is still unclear, but CBT and MBX have displayed the most significant effects based on current limited evidence. Future research in this area—preferably large robust randomized controlled trials—is much needed.