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. Mate...

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Detalhes bibliográficos
Autores: Hogg, Bridget, Radua, Joaquim, Gardoki Souto, Itxaso, Fontana McNally, Marta, Lupo, Walter, Reinares, María, Jiménez Martínez, Esther, Madre, Mercè, Blanco Presas, Laura, Cortizo, Romina, Massó Rodriguez, Anna, Castaño, Juan, Argila Plaza, Isabel, Castro Rodríguez, José Ignacio, Comes, Mercè, Macias, Cristina, Sánchez González, Roberto, Mur Milà, Estanislao, Novo, Patricia, Rosa, Adriane Ribeiro, Vieta i Pascual, Eduard, 1963-, Padberg, Frank, Pérez Solà, Víctor, Valiente Gómez, Alicia, Moreno Alcázar, Ana, Amann, Benedikt L.
Tipo de documento: artigo
Estado:Versión aceptada para publicación
Data de publicação:2024
País:España
Recursos:Universidad de Barcelona
Repositório:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/217100
Acesso em linha:https://hdl.handle.net/2445/217100
Access Level:Acceso aberto
Palavra-chave:Persones de mitjana edat
Psicoteràpia
Trastorn bipolar
Traumes psíquics
Assaigs clínics
Middle aged persons
Psychotherapy
Manic-depressive illness
Psychic trauma
Clinical trials
Descrição
Resumo: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 traumafocused 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 hospitalization. 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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