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

• DOI: 10.1192/j.eurpsy.2024.19
• Publication Date: 2024-03-07T11:04:22Z
• Authors: Martina Rojnic Ku...; Frank Padberg; Benedikt L. Amann; Meryam Schouler-Ocak; Zarko Bajic; Tarja Melartin; Adrian James; Julian Beezhold; Jordi Artigue Gómez; Celso Arango; Tihana Jendricko; Jamila Ismayilov; William Flannery; Egor Chumakov; Koray Başar; Simavi Vahip; Dominika Dudek; Jerzy Samochowiec; Goran Mihajlovic; Fulvia Rota; Gabriela Stoppe; Geert Dom; Kirsten Catthoor; Eka Chkonia; Maria João Heitor...; Diogo Telles; Peter Falkai; Philippe Courtet; Michal Patarák; Lubomira Izakova; Oleg Skugarevski; Stojan Barjaktarov; Dragan Babic; Goran Racetovic; Andrea Fiorillo; Bernardo Carpiniello; Maris Taube; Yuval Melamed; Jana Chihai; Doina Constanta M...; Pavel Mohr; György Szekeres; Mirjana Delic; Ramunė Mazaliausk...; Aleksandar Tomcuk; Nataliya Maruta; Philip Gorwood
• Keywords: Antidepressive Agents / therapeutic use; psychopharmacology; Psychiatry; Cognitive Behavioral Therapy; Psychopharmacology; Stress Disorders, Post-Traumatic / drug therapy; RC435-571; PTSD; Guidelines; EPA Policy Paper; Stress Disorders, Post-Traumatic / psychology; psychiatry; Antidepressive Agents; Neurology and psychiatry; Stress Disorders, Post-Traumatic; Europe; Humans; Mental health; Human medicine; guidelines; Psychiatrists; mental health

Abstract

Background 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).

Methods The case-based analysis included 611 participants, who correctly classified the vignette as a case of PTSD, from Central/ Eastern Europe (CEE) (n = 279), Southern Europe (SE) (n = 92), Northern Europe (NE) (n = 92), and Western Europe (WE) (N = 148).

Results 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 (N = 367), psychiatrists would less often recommend any antidepressants. In Class 2 (N = 51), clinicians would recommend trazodone and prolonged exposure therapy. In Class 3 (N = 65), they propose mirtazapine and eye movement desensitization reprocessing therapy. In Class 4 (N = 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.

Conclusions 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.