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

Published online by Cambridge University Press:  04 January 2024

Simonne Lesley Wright Open the ORCID record for Simonne Lesley Wright [Opens in a new window] ,
Eirini Karyotaki Open the ORCID record for Eirini Karyotaki [Opens in a new window] ,
Pim Cuijpers Open the ORCID record for Pim Cuijpers [Opens in a new window] ,
Jonathan Bisson Open the ORCID record for Jonathan Bisson [Opens in a new window] ,
Davide Papola Open the ORCID record for Davide Papola [Opens in a new window] ,
Anke Witteveen Open the ORCID record for Anke Witteveen [Opens in a new window] ,
Sharain Suliman Open the ORCID record for Sharain Suliman [Opens in a new window] ,
Georgina Spies Open the ORCID record for Georgina Spies [Opens in a new window] ,
Khodabakhsh Ahmadi Open the ORCID record for Khodabakhsh Ahmadi [Opens in a new window]  and
Liuva Capezzani
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Simonne Lesley Wright*
Affiliation:
South Africa PTSD Research Programme of Excellence, Department of Psychiatry, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa Department of Clinical, Neuro- and Developmental Psychology, World Health Organization Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
Eirini Karyotaki
Affiliation:
Department of Clinical, Neuro- and Developmental Psychology, World Health Organization Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
Pim Cuijpers
Affiliation:
Department of Clinical, Neuro- and Developmental Psychology, World Health Organization Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
Jonathan Bisson
Affiliation:
Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
Davide Papola
Affiliation:
Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
Anke Witteveen
Affiliation:
Department of Clinical, Neuro- and Developmental Psychology, World Health Organization Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
Sharain Suliman
Affiliation:
South Africa PTSD Research Programme of Excellence, Department of Psychiatry, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
Georgina Spies
Affiliation:
South Africa PTSD Research Programme of Excellence, Department of Psychiatry, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
Khodabakhsh Ahmadi
Affiliation:
Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
Liuva Capezzani
Affiliation:
The International Institute for Psychoanalytic Research and Training of Health Professionals (IIPRTHP), Rome, Italy International School for Psychotherapy (SIPSI), Rome, Italy
Sara Carletto
Affiliation:
Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
Thanos Karatzias
Affiliation:
School of Health & Social Care, Edinburgh Napier University, Edinburgh, Scotland
Claire Kullack
Affiliation:
Pax Centre, West Leederville, Australia
Jonathan Laugharne
Affiliation:
Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
Christopher William Lee
Affiliation:
Faculty of Health and Medical Sciences, The University of Western Australia, Crawley, Australia
Mirjam J. Nijdam
Affiliation:
Department of Psychiatry & Amsterdam Public Health, Amsterdam University Medical Center location University of Amsterdam, Amsterdam, The Netherlands ARQ National Psychotrauma Center, Diemen, The Netherlands
Miranda Olff
Affiliation:
Department of Psychiatry & Amsterdam Public Health, Amsterdam University Medical Center location University of Amsterdam, Amsterdam, The Netherlands ARQ National Psychotrauma Center, Diemen, The Netherlands
Luca Ostacoli
Affiliation:
Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
Soraya Seedat
Affiliation:
South Africa PTSD Research Programme of Excellence, Department of Psychiatry, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa South African Medical Research Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
Marit Sijbrandij
Affiliation:
Department of Clinical, Neuro- and Developmental Psychology, World Health Organization Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
*
Corresponding author: Simonne Lesley Wright; Email: s.l.wright@vu.nl
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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.

Keywords

EMDRindividual participant data meta-analysismoderatorsPTSDsystematic reviewtreatment
Type
Original Article
Information
Psychological Medicine , First View , pp. 1 - 9
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Copyright
Copyright © The Author(s), 2024. Published by Cambridge University Press

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