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PTSD Therapies Deemed Safe for Patients With Comorbid Psychosis

Prolonged exposure, eye movement desensitization/reprocessing tx found to be effective

WEDNESDAY, Jan. 21, 2015 (HealthDay News) -- For patients with psychotic disorders and comorbid posttraumatic stress disorder (PTSD), prolonged exposure (PE) therapy and eye movement desensitization and reprocessing (EMDR) therapy are safe and effective, according to a study published online Jan. 21 in JAMA Psychiatry.

David P.G. van den Berg, from the Parnassia Psychiatric Institute in Den Haag, Netherlands, and colleagues examined the safety and efficacy of PE therapy and EMDR therapy in patients with psychotic disorders and comorbid PTSD. Participants were randomized to receive eight weekly 90-minute sessions of PE therapy (53 patients), EMDR therapy (55 patients); and waiting list (WL; 47 patients) control.

The researchers observed a greater reduction in PTSD symptoms among participants in the PE and EMDR conditions versus those in the WL condition, with between-group effect sizes of 0.78 (P < 0.001) in PE and 0.65 (P = 0.001) in EMDR. Compared with those in the WL condition, participants in the PE condition and EMDR condition were more likely to achieve loss of diagnosis during treatment (56.6 and 60.0 versus 27.7 percent; odds ratios, 3.41 and 3.92, respectively). Participants in the PE condition were more likely than those in the WL condition to achieve full remission (28.3 versus 6.4 percent; odds ratio, 5.97). At the six month follow-up, treatment effects were maintained in PE and EMDR.

"A priori exclusion of individuals with psychosis from evidence-based PTSD treatments may not be justifiable," the authors write.

Several authors disclosed receipt of income from published books or chapters relating to PE and EMDR, and for training for professions in these therapies.

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