Background: The 11th revision to the WHO International Classification of Diseases (ICD-11) identified complex post-traumatic stress disorder (CPTSD) as a new condition. There is a pressing need to identify effective CPTSD interventions.Methods: We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) of psychological interventions for post-traumatic stress disorder (PTSD), where participants were likely to have clinically significant baseline levels of one or more CPTSD symptom clusters (affect dysregulation, negative self-concept and/or disturbed relationships). We searched MEDLINE, PsycINFO, EMBASE and PILOTS databases (January 2018), and examined study and outcome quality.Results: Fifty-one RCTs met inclusion criteria. Cognitive behavioural therapy (CBT), exposure alone (EA) and eye movement desensitisation and reprocessing (EMDR) were superior to usual care for PTSD symptoms, with effects ranging from g = −0.90 (CBT; k = 27, 95% CI −1.11 to −0.68; moderate quality) to g = −1.26 (EMDR; k = 4, 95% CI −2.01 to −0.51; low quality). CBT and EA each had moderate–large or large effects on negative self-concept, but only one trial of EMDR provided useable data. CBT, EA and EMDR each had moderate or moderate–large effects on disturbed relationships. Few RCTs reported affect dysregulation data. The benefits of all interventions were smaller when compared with non-specific interventions (e.g. befriending). Multivariate meta-regression suggested childhood-onset trauma was associated with a poorer outcome.Conclusions: The development of effective interventions for CPTSD can build upon the success of PTSD interventions. Further research should assess the benefits of flexibility in intervention selection, sequencing and delivery, based on clinical need and patient preferences.

The aim of this study was to evaluate the association of COVID-19 factors and psychological factors with psychological distress among dental staff during the COVID-19 pandemic outbreak. A cross-sectional survey was conducted among 338 Israeli dentists and dental hygienists, who provided their demographic data; answered questions about COVID-19-related factors; and were assessed by subjective overload, self-efficacy, and psychological distress scales. Data were analyzed using a multivariate logistic regression. Results revealed that elevated psychological distress was found among those who have background illness, fear of contracting COVID-19 from patient, and a higher subjective overload. Lower psychological distress was associated with being in a committed relationship and having higher scores for self-efficacy. Given these results, gathered during times of an infectious disease outbreak, exploring psychological distress among dental staff is warranted as the effects may be long-term.

Background: High rates of posttraumatic stress disorder (PTSD) have been documented in war‐affected populations. The prevalence of Complex PTSD (CPTSD) has never been assessed in an active war zone. Here, we provide initial data on war‐related experiences, and prevalence rates of ICD‐11 PTSD and CPTSD in a large sample of adults in Ukraine during the Russian war. We also examined how war‐related stressors, PTSD, and CPTSD were associated with age, sex, and living location in Ukraine.Method: Self‐report data were gathered from a nationwide sample of 2004 adult parents of children under 18 from the general population of Ukraine approximately 6 months after Russia's invasion.Results: All participants were exposed to at least one war‐related stressor, and the mean number of exposures was 9.07 (range = 1–26). Additionally, 25.9% (95% CI = 23.9%, 27.8%) met diagnostic requirements for PTSD and 14.6% (95% CI = 12.9%, 16.0%) met requirements for CPTSD. There was evidence of a strong dose–response relationship between war‐related stressors and meeting criteria for PTSD and CPTSD. Participants who had the highest exposure to war‐related stressors were significantly more likely to meet the requirements for PTSD (OR = 4.20; 95% CI = 2.96–5.95) and CPTSD (OR = 8.12; 95% CI = 5.11–12.91) compared to the least exposed.Conclusions: Humanitarian responses to the mental health needs of the Ukrainian population will need to take account of posttraumatic stress reactions. Education in diagnosing and treating PTSD/CPTSD, especially in the situation of a significant lack of human resources and continuing displacement of the population, is necessary.