Sanchez Daniel Folch, Blithikioti Chrysanthi, Piazza Flavia, Nuño Laura, Blanco Laura, Rodríguez-Rey Arturo, Muñoz-Moreno Emma, Balcells-Oliveró Mercè, Miquel Laia
Health and Addictions Research Group; Addictions Unit. Psychiatry and Psychology Service, ICN, Hospital Clinic Barcelona, Barcelona, Spain.
Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Eur J Psychotraumatol. 2025 Dec;16(1):2531595. doi: 10.1080/20008066.2025.2531595. Epub 2025 Aug 12.
Prior exposure to traumatic events significantly increases the risk of developing substance use disorders (SUD), while having SUD, in turn, elevates the likelihood of encountering additional traumatic events. Despite this relationship, the consequences of trauma frequently go undetected and untreated in this population. The trauma-focused intervention eye movement desensitisation and reprocessing (EMDR), a first-line treatment for post-traumatic stress disorder (PTSD), has shown promising therapeutic potential in SUD patients. However, its underlying neurobiological mechanisms remain unclear. This study aims to investigate the efficacy of EMDR in SUD patients with comorbid psychological trauma. Additionally, potential mechanisms of action of the intervention will be explored. The primary hypothesis is that integrating EMDR into standard SUD treatment will enhance substance use prognosis. Sixty-four patients with SUD and trauma symptomatology will be randomised into two groups. One group will receive EMDR trauma-focused intervention in 6-8 sessions alongside treatment as usual (TAU) ( = 32), while the control group will receive TAU only ( = 32). The primary outcome will be the time to relapse, assessed at baseline, immediately after treatment, and at 1- and 3-months follow-up. Additional measures include post-traumatic, anxiety, depressive symptoms and biological markers (hair/salivary cortisol levels, eye blink conditioning, and resting-state fMRI). Survival analysis and linear mixed models will be used to assess treatment effects. The trial is registered on ClinicalTrials.gov (NCT05488691).: This study addresses a critical gap in scientific literature and clinical practice by evaluating the efficacy of EMDR, in patients with SUD and comorbid trauma symptoms, through a combination of clinical and biological markers. The findings could lead to integration of personalised, trauma-focused interventions into public health services for patients with SUD.
先前暴露于创伤性事件会显著增加患物质使用障碍（SUD）的风险，而患有SUD反过来又会增加遭遇更多创伤性事件的可能性。尽管存在这种关系，但创伤的后果在该人群中常常未被发现和治疗。以创伤为重点的干预措施眼动脱敏再处理（EMDR）是创伤后应激障碍（PTSD）的一线治疗方法，已在SUD患者中显示出有前景的治疗潜力。然而，其潜在的神经生物学机制仍不清楚。本研究旨在调查EMDR对合并心理创伤的SUD患者的疗效。此外，还将探索该干预措施的潜在作用机制。主要假设是将EMDR纳入标准的SUD治疗将改善物质使用预后。64名有SUD和创伤症状的患者将被随机分为两组。一组将在接受常规治疗（TAU）的同时接受6 - 8次以EMDR为重点的创伤干预（n = 32），而对照组仅接受TAU（n = 32）。主要结局将是复发时间，在基线、治疗后立即以及1个月和3个月随访时进行评估。其他测量指标包括创伤后、焦虑、抑郁症状以及生物学标志物（头发/唾液皮质醇水平、眨眼条件反射和静息态功能磁共振成像）。将使用生存分析和线性混合模型来评估治疗效果。该试验已在ClinicalTrials.gov上注册（NCT05488691）。：本研究通过结合临床和生物学标志物评估EMDR对有SUD和合并创伤症状患者的疗效，填补了科学文献和临床实践中的一个关键空白。研究结果可能会导致将个性化的、以创伤为重点的干预措施纳入针对SUD患者的公共卫生服务中。
