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Hydrocortisone administration for reducing post-traumatic stress symptoms: A systematic review and meta-analysis
- Source :
- Psychoneuroendocrinology. 126
- Publication Year :
- 2020
-
Abstract
- Background Post-traumatic stress disorder (PTSD) is a debilitating disorder that is often accompanied by alterations in the hypothalamic-pituitary (HPA) axis. While there is abundant evidence for the efficacy of psychological therapies in reducing post-traumatic stress symptoms, barely anything is known about pharmacological interventions. Given the role of the HPA axis in the pathophysiology of PTSD, the aim of this study was to provide the first meta-analysis of Hydrocortisone as a potential treatment for this condition. Method A systematic review of randomized-controlled trials (RCTs) was conducted to investigate the efficacy of hydrocortisone in the prevention and curative treatment of post-traumatic stress symptoms. This study was pre-registered with the OSF (doi:10.17605/OSF.IO/GJAZF). Findings Eight studies (9 effect sizes) covering 362 participants met our inclusion criteria. We found that Hydrocortisone as compared to placebo significantly reduced PTSD symptoms (d = 0.96, 95% Cl 0.22–1.69 p = 0.011) and PTSD incidence (logRR = 0.85, 95% CI 1.12–1.59, p = 0.023). Subgroup analyses revealed a significant effect of Hydrocortisone when it was administered in a preventative context (d = 1.50; 95%CI 0.30–2.69, p = 0.014), but not when it was administered in a curative context (d = 0.28; 95%CI −0.11 to 0.66, p = 0.161). Conclusion Hydrocortisone appears to be a promising and efficient low-cost medication for the prevention of PTSD. However, the small number of included studies and their limited methodological quality emphasize the need for further rigorous studies in this field.
- Subjects :
- medicine.medical_specialty
Hydrocortisone
Endocrinology, Diabetes and Metabolism
Context (language use)
Placebo
Stress Disorders, Post-Traumatic
2738 Psychiatry and Mental Health
03 medical and health sciences
0302 clinical medicine
Endocrinology
Internal medicine
medicine
Humans
Methodological quality
Biological Psychiatry
Randomized Controlled Trials as Topic
10093 Institute of Psychology
Endocrine and Autonomic Systems
business.industry
Incidence (epidemiology)
Traumatic stress
Pathophysiology
1310 Endocrinology
030227 psychiatry
2712 Endocrinology, Diabetes and Metabolism
2807 Endocrine and Autonomic Systems
Psychiatry and Mental health
Treatment Outcome
Meta-analysis
150 Psychology
business
2803 Biological Psychiatry
030217 neurology & neurosurgery
medicine.drug
Subjects
Details
- ISSN :
- 18733360
- Volume :
- 126
- Database :
- OpenAIRE
- Journal :
- Psychoneuroendocrinology
- Accession number :
- edsair.doi.dedup.....ac3fc1f250bba9f98a4f59cdbab8128f