Clinician treatment choices for post-traumatic stress disorder: ambassadors survey of psychiatrists in 39 European countries.

Journal: European psychiatry : the journal of the Association of European Psychiatrists

Volume: 67

Issue: 1

Year of Publication: 2024

Affiliated Institutions:  Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb and School of Medicine, University of Zagreb, Zagreb, Croatia. Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian University (LMU), Munich, Germany. Psychiatric University Clinic of Charité at St. Hedwig Hospital Berlin, Berlin, Germany. Research Unit "Dr. Mirko Grmek", Psychiatric Clinic "Sveti Ivan", Zagreb, Croatia. Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland. Royal College of Psychiatrists, London, UK. Great Yarmouth Acute Service, Northgate Hospital/Norfolk & Suffolk NHS Foundation Trust, Great Yarmouth, UK. Faculty of Psychology, University of Barcelona, Barcelona, Spain. Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain. Vrapče Psychiatric University Clinic, Zagreb, Croatia. The National Mental Health Center, Baku, Azerbaijan. Department of Adult Psychiatry, Mater Misericordiae University Hospital, Dublin, Ireland. Department of Psychiatry and Addiction, Saint-Petersburg State University, Saint-Petersburg, Russia. Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey. Affective Disorders Unit, Department of Psychiatry, Ege University Medicine Faculty, Izmir, Turkey. Psychiatry and Department of Adult Psychiatry, Collegium Medicum Jagiellonian University, Cracow, Poland. Pomeranian Medical University in Szczecin, Szczecin, Poland. Clinic for Psychiatry, University of Kragujevac, Kragujevac, Serbia. Swiss Society for Psychiatry and Psychotherapy, Switzerland. MentAge - Counsil-Practice-Research, Basel, Switzerland. Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp (UAntwerp), Antwerp, Belgium. Department of Psychiatry, Tbilisi State Medical University, Tbilisi, Georgia. Psychiatry and Mental Health Department, Hospital Beatriz Ângelo, Loures, Portugal. Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal. Department of Emergency Psychiatry and Post Acute Care, Hôspital Lapeyronie, CHU Montpellier,Montpellier, France. Department of Psychiatry, Slovak Medical University, Bratislava, Slovakia. Department of Psychiatry, Faculty of Medicine, Comenius University Bratislava, Bratislava, Slovakia. Department of Psychiatry and Medical Psychology, Belarusian State Medical University, Minsk, Belarus. University Clinic of Psychiatry, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, Republic of North Macedonia. Psychiatry Clinic, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina. Community Mental Health Center, Health Center Prijedor, Prijedor, Bosnia and Herzegovina. Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy. University of Cagliari and Psychiatry Unit, Section of Psychiatry, Department of Medical Sciences and Public Health, University Hospital, Cagliari, Italy. Department of Psychiatry and Narcology, Riga Stradiņš University, Riga Centre of Psychiatry and Narcology, Riga, Latvia. Abarbanel Mental Health Center, Tel Aviv, Israel. Department of Mental Health, Medical Psychology and Psychotherapy, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova, Kishinev, Moldova. Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. Clinical Department, National Institute of Mental Health, Klecany, Czechia. Semmelweis University, Budapest, Hungary. University Psychiatric Clinic, Ljubljana, Slovenia. Psychiatric Clinic, Lithuanian Health Sciences University Kaunas Hospital, Kaunas, Lithuania. Special Psychiatric Hospital Kotor,Kotor, Montenegro. Institute of Neurology, Psychiatry and Narcology, National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine. Université Paris Cité, INSERM UMR, Paris, France.

Abstract summary 

Considering the recently growing number of potentially traumatic events in Europe, the European Psychiatric Association undertook a study to investigate clinicians' treatment choices for post-traumatic stress disorder (PTSD).The case-based analysis included 611 participants, who correctly classified the vignette as a case of PTSD, from Central/ Eastern Europe (CEE) ( = 279), Southern Europe (SE) ( = 92), Northern Europe (NE) ( = 92), and Western Europe (WE) ( = 148).About 82% woulduse antidepressants (sertraline being the most preferred one). Benzodiazepines and antipsychotics were significantly more frequently recommended by participants from CEE (33 and 4%, respectively), compared to participants from NE (11 and 0%) and SE (9% and 3%). About 52% of clinicians recommended trauma-focused cognitive behavior therapy and 35% psychoeducation, irrespective of their origin. In the latent class analysis, we identified four distinct "profiles" of clinicians. In Class 1 ( = 367), psychiatrists would less often recommend any antidepressants. In Class 2 ( = 51), clinicians would recommend trazodone and prolonged exposure therapy. In Class 3 ( = 65), they propose mirtazapine and eye movement desensitization reprocessing therapy. In Class 4 ( = 128), clinicians propose different types of medications and cognitive processing therapy. About 50.1% of participants in each region stated they do not adhere to recognized treatment guidelines.Clinicians' decisions for PTSD are broadly similar among European psychiatrists, but regional differences suggest the need for more dialogue and education to harmonize practice across Europe and promote the use of guidelines.

Authors & Co-authors:  Rojnic Kuzman Padberg Amann Schouler-Ocak Bajic Melartin James Beezhold Artigue Gómez Arango Jendricko Ismayilov Flannery Chumakov Başar Vahip Dudek Samochowiec Mihajlovic Rota Stoppe Dom Catthoor Chkonia Heitor Dos Santos Telles Falkai Courtet Patarák Izakova Skugarevski Barjaktarov Babic Racetovic Fiorillo Carpiniello Taube Melamed Chihai Cozman Mohr Szekeres Delic Mazaliauskienė Tomcuk Maruta Gorwood

Study Outcome 

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Statistics
Citations : 
Authors :  47
Identifiers
Doi : 10.1192/j.eurpsy.2024.19
SSN : 1778-3585
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
Europe;PTSD;guidelines;mental health;psychiatry;psychopharmacology
Study Design
Study Approach
Country of Study
Publication Country
England