Universität zu Köln

Schumacher, Sarah, Niemeyer, Helen, Engel, Sinha ORCID: 0000-0001-9289-7094, Cwik, Jan Christopher ORCID: 0000-0002-2290-353X and Knaevelsrud, Christine (2018). Psychotherapeutic treatment and HPA axis regulation in posttraumatic stress disorder: A systematic review and meta-analysis. Psychoneuroendocrinology, 98. S. 186 - 202. OXFORD: PERGAMON-ELSEVIER SCIENCE LTD. ISSN 0306-4530

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Abstract

Posttraumatic stress disorder (PTSD) has been associated with dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. Research over the past years has investigated potential changes of these alterations in the context of psychotherapy. Yet, no systematic review has been conducted. To summarize the current state of research on psychotherapy and HPA hormones, namely cortisol, dehydroepiandrosterone and its sulfate form (DHEA(S)), we searched for studies investigating predictions or changes in hormones over treatment course within the databases PubMed, Scopus, Medline, PsychINFO, Pilots/ProQuest, and Web of Science, and in the grey literature up to May 2018. Controlled and uncontrolled trials investigating adult samples with a clinical status of PTSD were eligible for inclusion. Twelve studies (428 participants) were included. Study quality was overall sufficient. Hormone assessment designs differed considerably. Treatment efficacy on PTSD symptom reduction was mostly high, but predictions of pre-treatment hormone concentrations on treatment efficacy were largely non-significant. Changes from pre- to post-test in basal cortisol (g = -0.07, 95% CI = -0.36; 0.21) and in the cortisol awakening response (g = -0.07, 95% CI = -0.48; 0.35) were also non-significant. Future studies require comparable designs and need to be sufficiently powered to be able to detect potential associations with HPA regulation.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schumacher, Sarah UNSPECIFIED UNSPECIFIED UNSPECIFIED Niemeyer, Helen UNSPECIFIED UNSPECIFIED UNSPECIFIED Engel, Sinha UNSPECIFIED orcid.org/0000-0001-9289-7094 UNSPECIFIED Cwik, Jan Christopher UNSPECIFIED orcid.org/0000-0002-2290-353X UNSPECIFIED Knaevelsrud, Christine UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-164307
DOI:	10.1016/j.psyneuen.2018.08.006
Journal or Publication Title:	Psychoneuroendocrinology
Volume:	98
Page Range:	S. 186 - 202
Date:	2018
Publisher:	PERGAMON-ELSEVIER SCIENCE LTD
Place of Publication:	OXFORD
ISSN:	0306-4530
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language REALITY EXPOSURE THERAPY; SALIVARY CORTISOL; COMBAT VETERANS; PTSD TREATMENT; DHEA-S; PREDICTOR; INTERVENTIONS; DEPRESSION; CLINICIAN; IMPACT Multiple languages Endocrinology & Metabolism; Neurosciences; Psychiatry Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16430