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...
| Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Tipo de recurso: | artículo |
| Estado: | Versión aceptada para publicación |
| Fecha de publicación: | 2024 |
| País: | España |
| Institución: | Universidad de Barcelona |
| Repositorio: | Dipòsit Digital de la UB |
| OAI Identifier: | oai:diposit.ub.edu:2445/217100 |
| Acceso en línea: | https://hdl.handle.net/2445/217100 |
| Access Level: | acceso abierto |
| Palabra clave: | Persones de mitjana edat Psicoteràpia Trastorn bipolar Traumes psíquics Assaigs clínics Middle aged persons Psychotherapy Manic-depressive illness Psychic trauma Clinical trials |
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EMDR therapy vs. supportive therapy as adjunctive treatment in trauma-exposed bipolar patients: A randomised controlled trialHogg, BridgetRadua, JoaquimGardoki Souto, ItxasoFontana McNally, MartaLupo, WalterReinares, MaríaJiménez Martínez, EstherMadre, MercèBlanco Presas, LauraCortizo, RominaMassó Rodriguez, AnnaCastaño, JuanArgila Plaza, IsabelCastro Rodríguez, José IgnacioComes, MercèMacias, CristinaSánchez González, RobertoMur Milà, EstanislaoNovo, PatriciaRosa, Adriane RibeiroVieta i Pascual, Eduard, 1963-Padberg, FrankPérez Solà, VíctorValiente Gómez, AliciaMoreno Alcázar, AnaAmann, Benedikt L.Persones de mitjana edatPsicoteràpiaTrastorn bipolarTraumes psíquicsAssaigs clínicsMiddle aged personsPsychotherapyManic-depressive illnessPsychic traumaClinical trialsIntroduction. 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. 2024info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfhttps://hdl.handle.net/2445/217100Articles publicats en revistes (Medicina)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésVersió postprint del document publicat a: https://doi.org/10.1016/j.sjpmh.2023.11.0052024, vol. 17, num.4, p. 203-214https://doi.org/10.1016/j.sjpmh.2023.11.005cc-by-nc-nd (c) Hogg, B. et al., 2024http://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/2171002026-05-27T06:46:51Z |
| dc.title.none.fl_str_mv |
EMDR therapy vs. supportive therapy as adjunctive treatment in trauma-exposed bipolar patients: A randomised controlled trial |
| title |
EMDR therapy vs. supportive therapy as adjunctive treatment in trauma-exposed bipolar patients: A randomised controlled trial |
| spellingShingle |
EMDR therapy vs. supportive therapy as adjunctive treatment in trauma-exposed bipolar patients: A randomised controlled trial Hogg, Bridget Persones de mitjana edat Psicoteràpia Trastorn bipolar Traumes psíquics Assaigs clínics Middle aged persons Psychotherapy Manic-depressive illness Psychic trauma Clinical trials |
| title_short |
EMDR therapy vs. supportive therapy as adjunctive treatment in trauma-exposed bipolar patients: A randomised controlled trial |
| title_full |
EMDR therapy vs. supportive therapy as adjunctive treatment in trauma-exposed bipolar patients: A randomised controlled trial |
| title_fullStr |
EMDR therapy vs. supportive therapy as adjunctive treatment in trauma-exposed bipolar patients: A randomised controlled trial |
| title_full_unstemmed |
EMDR therapy vs. supportive therapy as adjunctive treatment in trauma-exposed bipolar patients: A randomised controlled trial |
| title_sort |
EMDR therapy vs. supportive therapy as adjunctive treatment in trauma-exposed bipolar patients: A randomised controlled trial |
| dc.creator.none.fl_str_mv |
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. |
| author |
Hogg, Bridget |
| author_facet |
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. |
| author_role |
author |
| author2 |
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. |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
Persones de mitjana edat Psicoteràpia Trastorn bipolar Traumes psíquics Assaigs clínics Middle aged persons Psychotherapy Manic-depressive illness Psychic trauma Clinical trials |
| topic |
Persones de mitjana edat Psicoteràpia Trastorn bipolar Traumes psíquics Assaigs clínics Middle aged persons Psychotherapy Manic-depressive illness Psychic trauma Clinical trials |
| description |
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. |
| publishDate |
2024 |
| dc.date.none.fl_str_mv |
2024 |
| dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/acceptedVersion |
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article |
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acceptedVersion |
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https://hdl.handle.net/2445/217100 |
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https://hdl.handle.net/2445/217100 |
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Inglés |
| language_invalid_str_mv |
Inglés |
| dc.relation.none.fl_str_mv |
Versió postprint del document publicat a: https://doi.org/10.1016/j.sjpmh.2023.11.005 2024, vol. 17, num.4, p. 203-214 https://doi.org/10.1016/j.sjpmh.2023.11.005 |
| dc.rights.none.fl_str_mv |
cc-by-nc-nd (c) Hogg, B. et al., 2024 http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
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cc-by-nc-nd (c) Hogg, B. et al., 2024 http://creativecommons.org/licenses/by-nc-nd/4.0/ |
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openAccess |
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application/pdf |
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Articles publicats en revistes (Medicina) reponame:Dipòsit Digital de la UB instname:Universidad de Barcelona |
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Universidad de Barcelona |
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