Adams Rosie, Ohlsen Sally, Wood Emily
School of Nursing and Midwifery, The University of Sheffield, Sheffield, UK.
ScHARR, Mental Health Research Unit, The University of Sheffield, Sheffield, UK.
Eur J Psychotraumatol. 2020 Mar 10;11(1):1711349. doi: 10.1080/20008198.2019.1711349. eCollection 2020.
: Psychosis is a public health concern. There is increasing evidence suggesting trauma can play a pivotal role in the development and maintenance of psychosis. Eye Movement Desensitization and Reprocessing (EMDR) is an effective treatment for trauma and could be a vital addition to the treatment of psychosis. : To explore the evidence for EMDR as a treatment for psychosis, focussing on the safety, effectiveness and acceptability of this intervention for this population. : Four databases (Cochrane, EMBASE, MEDLINE PsychINFO), and the Francine Shapiro Library were systematically searched, along with grey literature and reference lists of relevant papers. No date limits were applied as this is an area of emerging evidence. Studies were screened for eligibility based on inclusion and exclusion criteria. The included studies were quality assessed and data was extracted from the individual studies, and synthesized using a narrative synthesis approach. : Six studies met the inclusion criteria (1 RCT, 2 Pilot studies, 2 Case series and 1 Case report). Across the studies EMDR was associated with reductions in delusional and negative symptoms, mental health service and medication use. Evidence for reductions in auditory hallucinations and paranoid thinking was mixed. No adverse events were reported, although initial increases in psychotic symptoms were observed in two studies. Average dropout rates across the studies were comparable to other trauma-focused treatments for PTSD. The acceptability of EMDR was not adequately measured or reported. : EMDR appears a safe and feasible intervention for people with psychosis. The evidence is currently insufficient to determine the effectiveness and acceptability of the intervention for this population. Larger confirmative trials are required to form more robust conclusions.
精神病是一个公共卫生问题。越来越多的证据表明，创伤在精神病的发生和维持中可能起关键作用。眼动脱敏再处理疗法（EMDR）是一种治疗创伤的有效方法，可能是精神病治疗的重要补充。
为了探索眼动脱敏再处理疗法作为精神病治疗方法的证据，重点关注该干预措施对这一人群的安全性、有效性和可接受性。
系统检索了四个数据库（Cochrane、EMBASE、MEDLINE、PsychINFO）以及弗朗辛·夏皮罗图书馆，同时检索了灰色文献和相关论文的参考文献列表。由于这是一个新出现证据的领域，未设置日期限制。根据纳入和排除标准对研究进行筛选以确定其是否符合条件。对纳入的研究进行质量评估，并从各个研究中提取数据，采用叙述性综合方法进行综合分析。
六项研究符合纳入标准（1项随机对照试验、2项试点研究、2个病例系列和1篇病例报告）。在各项研究中，眼动脱敏再处理疗法与妄想和阴性症状、心理健康服务及药物使用的减少有关。关于幻听和偏执思维减少的证据不一。尽管两项研究中观察到精神病症状最初有所增加，但未报告不良事件。各项研究的平均脱落率与其他针对创伤后应激障碍的以创伤为重点的治疗方法相当。眼动脱敏再处理疗法的可接受性未得到充分测量或报告。
眼动脱敏再处理疗法似乎是一种对患有精神病的人安全可行的干预措施。目前的证据不足以确定该干预措施对这一人群的有效性和可接受性。需要进行更大规模的验证性试验以得出更可靠的结论。
