Bridget Hogg , Joaquim Radua , Itxaso Gardoki-Souto , Marta Fontana-McNally , Walter Lupo , María Reinares , Esther Jiménez , Mercè Madre , Laura Blanco-Presas , Romina Cortizo , Anna Massó-Rodriguez , Juan Castaño , Isabel Argila , José Ignacio Castro-Rodriguez , Mercè Comes , Cristina Macias , Roberto Sánchez-González , Estanislao Mur-Mila , Patricia Novo , Adriane R. Rosa , Benedikt L. Amann
{"title":"EMDR疗法与辅助疗法作为创伤暴露型躁郁症患者的辅助治疗：随机对照试验","authors":"Bridget Hogg , Joaquim Radua , Itxaso Gardoki-Souto , Marta Fontana-McNally , Walter Lupo , María Reinares , Esther Jiménez , Mercè Madre , Laura Blanco-Presas , Romina Cortizo , Anna Massó-Rodriguez , Juan Castaño , Isabel Argila , José Ignacio Castro-Rodriguez , Mercè Comes , Cristina Macias , Roberto Sánchez-González , Estanislao Mur-Mila , Patricia Novo , Adriane R. Rosa , Benedikt L. Amann","doi":"10.1016/j.sjpmh.2023.11.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div><span><span>Patients with bipolar disorder (BD) are frequently exposed to traumatic events which worsen </span>disease course, but this study is the first multicentre </span>randomised controlled trial to test the efficacy of a trauma-focused adjunctive psychotherapy in reducing BD affective relapse rates.</div></div><div><h3>Materials and methods</h3><div><span><span><span>This multicentre randomised controlled trial included 77 patients with BD and current trauma-related symptoms. Participants were randomised to either 20 sessions of trauma-focused </span>Eye Movement Desensitization and Reprocessing<span><span> (EMDR) therapy for BD, or 20 sessions of supportive therapy (ST). The primary outcome was relapse rates over 24-months, and secondary outcomes were improvements in affective and trauma symptoms, general functioning, and </span>cognitive impairment, assessed at baseline, post-treatment, and at 12- and 24-month follow-up. The trial was registered prior to starting enrolment in </span></span>clinical trials (</span><span><span>NCT02634372</span><svg><path></path></svg></span>) and carried out in accordance with CONSORT guidelines.</div></div><div><h3>Results</h3><div>There was no significant difference between treatment conditions in terms of relapse rates either with or without hospitalisation. EMDR was significantly superior to ST at the 12-month follow up in terms of reducing depressive symptoms (<em>p</em> <!-->=<!--> <!-->0.0006, <em>d</em> <!-->=<!--> <!-->0.969), manic symptoms (<em>p</em> <!-->=<!--> <!-->0.027, <em>d</em> <!-->=<!--> <!-->0.513), and improving functioning (<em>p</em> <!-->=<!--> <!-->0.038, <em>d</em> <!-->=<!--> <!-->0.486). There was no significant difference in dropout between treatment arms.</div></div><div><h3>Conclusions</h3><div>Although the primary efficacy criterion was not met in the current study, trauma-focused EMDR was superior to ST in reducing of affective symptoms and improvement of functioning, with benefits maintained at six months following the end of treatment. Both EMDR and ST reduced trauma symptoms as compared to baseline, possibly due to a shared benefit of psychotherapy. Importantly, focusing on traumatic events did not increase relapses or dropouts, suggesting psychological trauma can safely be addressed in a BD population using this protocol.</div></div>","PeriodicalId":101179,"journal":{"name":"Spanish Journal of Psychiatry and Mental Health","volume":"17 4","pages":"Pages 203-214"},"PeriodicalIF":0.0000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"EMDR therapy vs. supportive therapy as adjunctive treatment in trauma-exposed bipolar patients: A randomised controlled trial\",\"authors\":\"Bridget Hogg , Joaquim Radua , Itxaso Gardoki-Souto , Marta Fontana-McNally , Walter Lupo , María Reinares , Esther Jiménez , Mercè Madre , Laura Blanco-Presas , Romina Cortizo , Anna Massó-Rodriguez , Juan Castaño , Isabel Argila , José Ignacio Castro-Rodriguez , Mercè Comes , Cristina Macias , Roberto Sánchez-González , Estanislao Mur-Mila , Patricia Novo , Adriane R. Rosa , Benedikt L. Amann\",\"doi\":\"10.1016/j.sjpmh.2023.11.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><div><span><span>Patients with bipolar disorder (BD) are frequently exposed to traumatic events which worsen </span>disease course, but this study is the first multicentre </span>randomised controlled trial to test the efficacy of a trauma-focused adjunctive psychotherapy in reducing BD affective relapse rates.</div></div><div><h3>Materials and methods</h3><div><span><span><span>This multicentre randomised controlled trial included 77 patients with BD and current trauma-related symptoms. Participants were randomised to either 20 sessions of trauma-focused </span>Eye Movement Desensitization and Reprocessing<span><span> (EMDR) therapy for BD, or 20 sessions of supportive therapy (ST). The primary outcome was relapse rates over 24-months, and secondary outcomes were improvements in affective and trauma symptoms, general functioning, and </span>cognitive impairment, assessed at baseline, post-treatment, and at 12- and 24-month follow-up. The trial was registered prior to starting enrolment in </span></span>clinical trials (</span><span><span>NCT02634372</span><svg><path></path></svg></span>) and carried out in accordance with CONSORT guidelines.</div></div><div><h3>Results</h3><div>There was no significant difference between treatment conditions in terms of relapse rates either with or without hospitalisation. EMDR was significantly superior to ST at the 12-month follow up in terms of reducing depressive symptoms (<em>p</em> <!-->=<!--> <!-->0.0006, <em>d</em> <!-->=<!--> <!-->0.969), manic symptoms (<em>p</em> <!-->=<!--> <!-->0.027, <em>d</em> <!-->=<!--> <!-->0.513), and improving functioning (<em>p</em> <!-->=<!--> <!-->0.038, <em>d</em> <!-->=<!--> <!-->0.486). There was no significant difference in dropout between treatment arms.</div></div><div><h3>Conclusions</h3><div>Although the primary efficacy criterion was not met in the current study, trauma-focused EMDR was superior to ST in reducing of affective symptoms and improvement of functioning, with benefits maintained at six months following the end of treatment. Both EMDR and ST reduced trauma symptoms as compared to baseline, possibly due to a shared benefit of psychotherapy. Importantly, focusing on traumatic events did not increase relapses or dropouts, suggesting psychological trauma can safely be addressed in a BD population using this protocol.</div></div>\",\"PeriodicalId\":101179,\"journal\":{\"name\":\"Spanish Journal of Psychiatry and Mental Health\",\"volume\":\"17 4\",\"pages\":\"Pages 203-214\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Spanish Journal of Psychiatry and Mental Health\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2950285323001126\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"0\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spanish Journal of Psychiatry and Mental Health","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2950285323001126","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"0","JCRName":"PSYCHIATRY","Score":null,"Total":0}
EMDR therapy vs. supportive therapy as adjunctive treatment in trauma-exposed bipolar patients: A randomised controlled trial
Introduction
Patients with bipolar disorder (BD) are frequently exposed to traumatic events which worsen disease course, but this study is the first multicentre randomised controlled trial to test the efficacy of a trauma-focused adjunctive psychotherapy in reducing BD affective relapse rates.
Materials and methods
This multicentre randomised controlled trial included 77 patients with BD and current trauma-related symptoms. Participants were randomised to either 20 sessions of trauma-focused Eye Movement Desensitization and Reprocessing (EMDR) therapy for BD, or 20 sessions of supportive therapy (ST). The primary outcome was relapse rates over 24-months, and secondary outcomes were improvements in affective and trauma symptoms, general functioning, and cognitive impairment, assessed at baseline, post-treatment, and at 12- and 24-month follow-up. The trial was registered prior to starting enrolment in clinical trials (NCT02634372) and carried out in accordance with CONSORT guidelines.
Results
There was no significant difference between treatment conditions in terms of relapse rates either with or without hospitalisation. EMDR was significantly superior to ST at the 12-month follow up in terms of reducing depressive symptoms (p = 0.0006, d = 0.969), manic symptoms (p = 0.027, d = 0.513), and improving functioning (p = 0.038, d = 0.486). There was no significant difference in dropout between treatment arms.
Conclusions
Although the primary efficacy criterion was not met in the current study, trauma-focused EMDR was superior to ST in reducing of affective symptoms and improvement of functioning, with benefits maintained at six months following the end of treatment. Both EMDR and ST reduced trauma symptoms as compared to baseline, possibly due to a shared benefit of psychotherapy. Importantly, focusing on traumatic events did not increase relapses or dropouts, suggesting psychological trauma can safely be addressed in a BD population using this protocol.
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