The efficacy of internet-delivered cognitive-behavioral therapy for posttraumatic stress disorder according to the mean age of patients: a systematic review and meta-analysis.

Internet-delivered cognitive-behavioral therapy (I-CBT) is effective in treating post-traumatic stress disorder (PTSD) symptoms, offering enhanced accessibility and cost-effectiveness. However, it's important to note that these technologies may not be suitable for all age groups. Therefore, we conducted a systematic review and meta-analysis to determine if the effectiveness of I-CBT in treating PTSD varies based on the patients' mean age. We conducted a systematic review of the literature, focusing on randomized controlled trials (RCTs) in the ISI Web of Science, PubMed/MEDLINE, and PsycINFO databases. Following this, we performed a meta-analysis and evaluated the risk of bias using the Cochrane risk of bias quality assessment tool. In this study, we examined patient-related factors (civil or military status, age, and gender), clinical characteristics (baseline PTSD severity and type of trauma), and treatment characteristics (type of intervention, synchronous or asynchronous delivery, and the number of sessions) as independent variables. The dependent variable was the reduction in mean PTSD symptoms. Five RCTs out of 1,552 screened studies were included in this review, all of which showed some level of concern regarding potential bias. Our meta-analysis indicates that I-CBT is equally effective regardless of patients' mean age. Since all RCTs included only provide the mean age of the patients, further randomized controlled trials should address the effectiveness of I-CBT among different age groups.

Possible outcomes of cumulative trauma in mental-health: a case report / Possíveis desfechos para trauma cumulativo na saúde mental: um relato de caso

ABSTRACT To discuss the resilience factors that may have prevented a patient from developing post-traumatic stress disorder (PTSD) after exposure to a variety of severe potentially traumatic events. A thirty-eight-year-old civilian has been exposed to at least ten dramatic situations of violence in his work and personal life. He developed only a few mild post-traumatic symptoms after being exposed to a particularly gruesome incident during work. Even though the number and severity of potentially traumatic events may be alarming, this does not determine that the patient will inexorably develop PTSD, or other disorders. The study of protective factors is mandatory so that we can acknowledge and develop more effective ways to prevent and treat disorders.

RESUMO Discutir fatores de resiliência que podem ter prevenido que um paciente desenvolvesse transtorno do estresse pós-traumático (TEPT) após a exposição a uma variedade de eventos potencialmente traumáticos severos. Um civil de 38 anos que foi exposto a, ao menos, 10 situações dramáticas de violência em seu trabalho e vida pessoal. Ele desenvolveu apenas alguns sintomas leves após o trauma de ter sido exposto a um evento particularmente desconcertante durante seu trabalho. Apesar de o número e a severidade dos eventos potencialmente traumáticos serem alarmantes, isso não determina que o paciente invariavelmente apresentará o TEPT ou outros transtornos. O estudo dos fatores protetivos é essencial para que possamos reconhecer e desenvolver maneiras efetivas de prevenir e tratar os transtornos mentais.