The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China; The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
Office of Education, Duke-NUS Graduate Medical School, Singapore, Singapore; Department of Psychosis & East Region, Institute of Mental Health, Singapore, Singapore.
Schizophr Res. 2023 Jun;256:1-7. doi: 10.1016/j.schres.2023.04.003. Epub 2023 Apr 26.
Post-traumatic stress disorder (PTSD) is highly prevalent in the individuals at clinical-high risk for psychosis (CHR). The aim of this study was to examine the efficacy and safety of Eye Movement Desensitization and Reprocessing (EMDR) in individuals at CHR with comorbid PTSD or subthreshold PTSD in a randomized controlled trial.
Fifty-seven individuals at CHR with PTSD or subthreshold PTSD formed the study sample. The eligible participants were randomly assigned to a 12 weeks EMDR treatment (N = 28) or a waiting list condition (WL, N = 29). The structured interview for psychosis risk syndrome (SIPS), the clinician administered post-traumatic stress disorder scale (CAPS) and a battery of self-rating inventories covering depressive, anxiety and suicidal symptoms were administered.
Twenty-six participants in the EMDR group and all the participants in the WL group completed the study. The analyses of covariance revealed greater reduction of the mean scores on CAPS (F = 23.2, Partial η = 0.3, P < 0.001), SIPS positive scales (F = 17.8, Partial η = 0.25, P < 0.001) and all the self-rating inventories in the EMDR group than in the WL group. Participants in the EMDR group were more likely to achieve remission of CHR compared to those in the WL group at endpoint (60.7 % vs. 31 %, P = 0.025).
EMDR treatment not only effectively improved traumatic symptoms, but also significantly reduced the attenuated psychotic symptoms and resulted in a higher remission rate of CHR. This study highlighted the necessity of adding a trauma-focused component to the present approach of early intervention in psychosis.
创伤后应激障碍（PTSD）在有精神病临床高风险（CHR）的个体中非常普遍。本研究的目的是在一项随机对照试验中，检查眼动脱敏再处理（EMDR）在伴有 PTSD 或阈下 PTSD 的 CHR 个体中的疗效和安全性。
57 名有 PTSD 或阈下 PTSD 的 CHR 个体构成了研究样本。符合条件的参与者被随机分配到为期 12 周的 EMDR 治疗组（N=28）或等待名单对照组（WL，N=29）。使用精神病风险综合征的结构化访谈（SIPS）、临床医生管理的创伤后应激障碍量表（CAPS）和一套涵盖抑郁、焦虑和自杀症状的自我评估量表进行评估。
EMDR 组的 26 名参与者和 WL 组的所有参与者都完成了研究。协方差分析显示，EMDR 组的 CAPS（F=23.2，部分η=0.3，P<0.001）、SIPS 阳性量表（F=17.8，部分η=0.25，P<0.001）和所有自我评估量表的平均分下降幅度更大，而 WL 组的降幅较小。与 WL 组相比，EMDR 组在终点时更有可能达到 CHR 的缓解（60.7%比 31%，P=0.025）。
EMDR 治疗不仅有效改善了创伤后症状，而且显著降低了减弱的精神病症状，并导致 CHR 的缓解率更高。本研究强调了在精神病早期干预中增加创伤焦点成分的必要性。
