What type of study is this?

This is a Meta-Analysis study (also classified as: Systematic Review, RCT, Pre-Registered Trial).

August 20, 2025Open Access

Efficacy of psychological interventions for adult PTSD in reducing comorbid depression: systematic review and meta-analysis of randomised controlled trials

THThole H. HoppenUniversity of Münster ALAnna S. LindemannUniversity of Münster LHLuisa HoferCenter for Integrated Protein Science Munich

Key Points

Post-treatment, trauma-focused cognitive behaviour therapy (TF-CBT) significantly reduced depression in individuals with PTSD.
The meta-analysis included 136 randomised controlled trials involving 8868 participants, showcasing substantial improvements in depression outcomes.
Observational data revealed TF-CBT consistently outperformed non-trauma-focused interventions in reducing depression across various timeframes.
Efficacy findings support the integration of PTSD-specific psychotherapies in clinical settings, emphasizing TF-CBT as particularly effective.

Abstract

Post-traumatic stress disorder (PTSD) and depression are highly comorbid. A comprehensive meta-analysis on the efficacy of PTSD-specific psychotherapies in reducing comorbid depression is lacking. To examine the short-, mid- and long-term efficacy of PTSD-specific psychotherapies in reducing comorbid depression. We performed a preregistered (Prospero-ID: CRD42023479224) meta-analysis and followed PRISMA guidelines. PsycINFO, MEDLINE, Web of Science and PTSDpubs were searched. Randomised controlled trials (RCTs) examining psychotherapies for PTSD in samples with ≥70% PTSD diagnosis rate, mean age of sample ≥18 years, ≥10 participants per group and reporting of depression outcome data were included in the meta-analysis. In total, 136 RCTs (N = 8868) assessed depression. Most data concerned trauma-focused cognitive behaviour therapy (TF-CBT), followed by eye movement desensitisation and reprocessing and non-trauma-focused and other trauma-focused interventions. At post-treatment, TF-CBT was associated with large reductions in depression relative to passive controls (Hedges' g = 0.97, 95% CI 0.80-1.14, k = 46 trials) and moderate reductions relative to active controls (Hedges' g = 0.50, 95% CI 0.35-0.65, k = 29). Effects relative to control conditions were similar across the other interventions. Response rates for comorbid depression were three times higher in psychological interventions relative to passive controls (odds ratio 3.07, 95% CI 1.18-7.94, k = 4). In head-to-head comparisons, there was evidence for TF-CBT producing higher short-, mid- and long-term reductions in depression than non-trauma-focused interventions. Results at mid- and long term were generally similar to those at treatment end-point. PTSD-specific psychotherapies are effective in reducing depression. TF-CBT presented with the highest certainty of results. More long-term data for other interventions are needed. Results are encouraging for clinical practice.

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Cite This Study

Hoppen et al. (Wed,) studied this question.

synapsesocial.com/papers/68af4ec0ad7bf08b1ead7b11 https://doi.org/https://doi.org/10.1192/bjp.2025.10345

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