Psychological interventions for adult earthquake-related post-traumatic stress disorder: systematic review and meta-analysis.

BACKGROUND

A minority of earthquake-exposed individuals develop post-traumatic stress disorder (PTSD), often alongside comorbid depression and anxiety symptoms. No systematic review has examined psychological interventions for adults with substantial earthquake-related PTSD symptoms.

AIMS: To synthesise studies evaluating psychological interventions for adult earthquake-related PTSD and conduct meta-analyses estimating overall effect sizes.

METHOD: The review was pre-registered with PROSPERO (CRD42023441020). PsycINFO, MEDLINE, EMBASE, CINAHL and Scopus were searched for studies (last search conducted July 2024). Randomised controlled trials (RCTs), non-randomised and non-controlled studies evaluating psychological interventions for adults with substantial earthquake-related PTSD symptoms were eligible. Outcomes were PTSD, depression and anxiety symptoms. Narrative syntheses and meta-analyses summarised study findings. The Mixed Methods Appraisal Tool guided quality assessments.

RESULTS

Sixteen studies were identified (eight RCTs, four non-randomised and four non-controlled studies), representing 1315 participants receiving psychological intervention. Interventions included cognitive behavioural therapy (CBT), specific CBT variants, eye movement desensitisation and reprocessing, interpersonal psychotherapy and an internet-based intervention focusing on social cognitive theory. Studies generally reported statistically and clinically significant improvements associated with psychological interventions. Among studies included in meta-analyses, overall effect size was 2.11 (95% CI = 0.92, 3.31) for PTSD symptoms and 1.01 (95% CI = 0.50, 1.52) for depression symptoms.

CONCLUSIONS

Psychological interventions are associated with good outcomes among adults with earthquake-related PTSD. The most evidence currently exists for CBT-based interventions, which are recommended as first-line treatments. Efficient intervention options, including single-session and group-based treatments, also show promise and are recommended for addressing widespread treatment need.