Meditation for Posttraumatic Stress Disorder: A Systematic Review
RAND National Defense Research Institute Santa Monica United States
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Posttraumatic stress disorder PTSD is a debilitating condition that emerges after exposure to a traumatic event. Meditation may provide a safe, self-administered, and inexpensive complement to first-line treatments for PTSD. This systematic review synthesized evidence on meditation interventions for the treatment of PTSD PROSPERO 2015 CRD42015025782. We searched eight electronic databases from inception to November 2015 and bibliographies of existing systematic reviews to identify English-language randomized controlled trials RCTs evaluating the efficacy and safety of meditation interventions in patients with PTSD. Two independent reviewers screened identified literature using predetermined eligibility criteria, abstracted study-level information, and assessed study quality. Meta-analyses used the Hartung-Knapp-Sidik-Jonkman method for random-effects models. The quality of evidence was assessed using the GRADE approach. The primary outcome was PTSD symptom severity, and other outcomes included depression, anxiety, quality of life, functional status, and adverse events. Ten RCTs on meditation interventions for PTSD met inclusion criteria, including five studies of mindfulness-based stress reduction, three of yoga, and two of the mantram repetition program. Meditation approach, intervention intensity, and study quality varied considerably. Eight RCTs included patients exposed to combat-associated trauma, six of which focused exclusively on combat-related trauma. Meditation interventions offered as adjunctive therapy reduced PTSD symptoms post-intervention compared with all comparators treatment as usual alone, attention matched control groups, present-centered group therapy across all types of trauma SMD 0.41CI 0.81, 0.01 8 RCTs I2 67 n517 low quality of evidence. Meditation was also effective in reducing depression symptoms SMD 0.34 CI 0.59, 0.08 8 RCTs I2 24 n523 moderate quality of evidence.
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