TOPLINE:

A systematic review of 10 randomised controlled trials (RCTs) found that trauma-based psychological treatments were superior to usual care in reducing depressive symptoms in older adults with posttraumatic stress disorder (PTSD), although the evidence for the reduction in PTSD symptoms was limited.

METHODOLOGY:

• Researchers conducted a systematic review and meta-analysis by searching seven databases up to January 2025 for RCTs on PTSD treatments in people aged 60 years or older.
• A total of 10 RCTs were included, reporting on the effectiveness of narrative exposure therapy (four trials), cognitive behavioural therapy (two trials), spiritual-focused psychotherapy (one trial), life review therapy (one trial), collaborative care (one trial), and physical activity (one trial).
• No trials evaluating the effectiveness of pharmacologic treatments for PTSD in older adults were identified during the search period.
• The primary outcome was the difference in symptom severity and remission rates of PTSD. The key secondary outcome was depressive symptoms.

TAKEAWAY:

• Trauma-based psychological treatments significantly reduced the depressive symptoms post-treatment compared with usual care (standardised mean difference [SMD], -0.48; 95% CI, -0.74 to -0.23; moderate-certainty evidence; seven studies; n = 504).
• Trauma-based psychological treatments also reduced symptoms of PTSD post-treatment compared with usual care, but the certainty of this evidence was low (SMD, -0.29; 95% CI, -0.62 to 0.03; five studies; n = 261).
• At long-term follow-up (6-8 months), trauma-based treatments were not significantly different from usual care in reducing PTSD symptoms, on the basis of low-certainty evidence.

IN PRACTICE:

"Our findings underscore the value of trauma-focused interventions in improving mental health outcomes for older people affected by trauma, in both community and long-term care settings where access to formal mental health services may be limited," the authors wrote. "For researchers and policymakers, the absence of high-quality trials highlights a pressing need to prioritise investigations into both pharmacological and non-pharmacological interventions tailored to older populations," they added.

SOURCE:

This study was led by Denise Gómez-Bautista, University College London, London, England. It was published online on October 15, 2025, in the Journal of Affective Disorders.

LIMITATIONS:

The meta-analysis included a limited number of studies, with many RCTs having small sample sizes. Nearly half of the studies focused on PTSD in men who were war veterans, limiting the generalisability of the findings to the wider population, particularly women. A limited number of trials compared interventions to usual care, and several studies showed an unclear or high risk of bias. Researchers were unable to control for treatment modality effects, trauma types, and comorbidities in their analysis.

DISCLOSURES:

This review was funded by University College London's Grand Challenges on Mental Health & Wellbeing. The authors reported having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.