Couples' therapies can improve clinical outcomes of patients with post-traumatic stress disorder: meta-analysis of eighteen clinical studies.

BACKGROUND: Partners play an important role in a couple's life, and the whole family may face various challenges when meeting post-traumatic stress disorder (PTSD). This study aimed to explore the therapeutic effect of couples' therapies for PTSD. METHODS: This study obtained relevant data from databases including Ovid Medline(R) ALL, Ovid Embase, Cochrane Central Register of Controlled Trials, and American Psychological Association PsycInfo until July 03, 2025. RESULTS: The couples' therapies showed an adherence rate (Proportion = 69%, 95%CI: 64% to 73%). Comparing with before couples' therapies, there were significant improvement in for patients (SMD = -0.79, 95%CI: -1.13 to -0.46) and for partners (SMD = -0.78, 95%CI: -1.05 to -0.52) after therapy, and there were significant improvement in intimate relationship functioning for patients (SMD = 0.27, 95%CI: 0.12 to 0.42) and partners (SMD = 0.38, 95%CI: 0.20 to 0.56), and in depression level for patients (SMD = -0.61, 95%CI: -0.82 to -0.40) and partners (SMD = -0.29, 95%CI: -0.50 to -0.07) after couples' therapies. Outcomes included comparisons with subgroup analysis which revealed that PTSD symptoms had better consequence for patients in age < 40 (SMD = -1.04, 95%CI: -1.93 to -0.16), male (SMD = -1.48, 95%CI: -1.95 to -1.01), and sessions ≥ 10 (SMD = -1.14, 95%CI: -1.53 to -0.74), trauma-focused (SMD = -1.17, 95%CI: -1.60 to -0.73), non-military personnel (SMD = -1.37, 95%CI: -1.94 to -0.79) and CBCT (SMD = -0.87, 95%CI: -1.24 to -0.49) had preferable outcomes for in PTSD symptoms. CONCLUSIONS: This study demonstrated the improvement of couples' therapies in PTSD symptoms, intimate relationship functioning and depression level. It was also found that the adherence rate of couples' therapies for PTSD was higher in Males, and the PTSD symptoms showed more conspicuous improvement in patients younger than 40 years of age, males, longer sessions of therapy, trauma-focused and CBCT after couples' therapies. TRIAL REGISTRATION: The protocol of meta-analysis was available at the Open Science Framework ( https://osf.io/s39jn/ ).