EMDR v. other psychological therapies for PTSD: a systematic review and individual participant data meta-analysis

眼动脱敏与再处理 荟萃分析 临床心理学 随机对照试验 人口 心理学 医学 认知行为疗法 适度 精神科 创伤后应激 内科学 社会心理学 环境卫生
作者
Simonne Wright,Eirini Karyotaki,Pim Cuijpers,Jonathan I. Bisson,Davide Papola,Anke B. Witteveen,Sharain Suliman,Georgina Spies,Khodabakhsh Ahmadi,Liuva Capezzani,Sara Carletto,Thanos Karatzias,Claire Kullack,Jonathan Laugharne,Christopher W. Lee,Mirjam J. Nijdam,Miranda Olff,Luca Ostacoli,Soraya Seedat,Marit Sijbrandij
出处
期刊:Psychological Medicine [Cambridge University Press]
卷期号:: 1-9
标识
DOI:10.1017/s0033291723003446
摘要

Abstract Background This systematic review and individual participant data meta-analysis (IPDMA) examined the overall effectiveness of eye movement desensitization and reprocessing (EMDR) in reducing posttraumatic stress disorder (PTSD) symptoms, achieving response and remission, and reducing treatment dropout among adults with PTSD compared to other psychological treatments. Additionally, we examined available participant-level moderators of the efficacy of EMDR. Methods This study included randomized controlled trials. Eligible studies were identified by a systematic search in PubMed, Embase, PsyclNFO, PTSDpubs, and CENTRAL. The target population was adults with above-threshold baseline PTSD symptoms. Trials were eligible if at least 70% of study participants had been diagnosed with PTSD using a structured clinical interview. Primary outcomes included PTSD symptom severity, treatment response, and PTSD remission. Treatment dropout was a secondary outcome. The systematic search retrieved 15 eligible randomized controlled trials (RCTs); 8 of these 15 were able to be included in this IPDMA (346 patients). Comparator treatments included relaxation therapy, emotional freedom technique, trauma-focused cognitive behavioral psychotherapies, and REM-desensitization. Results One-stage IPDMA found no significant difference between EMDR and other psychological treatments in reducing PTSD symptom severity ( β = −0.24), achieving response ( β = 0.86), attaining remission ( β = 1.05), or reducing treatment dropout rates ( β = −0.25). Moderator analyses found unemployed participants receiving EMDR had higher PTSD symptom severity at the post-test, and males were more likely to drop out of EMDR treatment than females. Conclusion The current study found no significant difference between EMDR and other psychological treatments. We found some indication of the moderating effects of gender and employment status.

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