title: Effectiveness of EMDR in patients with substance use disorder and comorbid PTSD: study protocol for a randomized controlled trial.
abstract: Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based treatment for PTSD. However, it is unclear whether EMDR shows the same effectiveness in patients with substance use disorders (SUD) and comorbid PTSD. In this trial, we examine the effectiveness of EMDR in reducing PTSD symptoms in patients with SUD and PTSD.
  
  
  
  We conduct a single-blinded RCT among 158 patients with SUD and comorbid PTSD admitted to a German addiction rehabilitation center specialized for the treatment of patients with SUD and comorbid PTSD. Patients are randomized to receive either EMDR, added to SUD rehabilitation and non-trauma-focused PTSD treatment (TAU), or TAU alone. The primary outcome is change from baseline in PTSD symptom severity as measured by the Clinician-Administered PTSD Scale at 6-month follow-up. Secondary outcomes are change from baseline in substance use, addiction-related problems, depressive symptoms, dissociative symptoms, emotion dysregulation and quality of life. Assessments are carried out by blinded raters at admission, at end of treatment, and at 3- and 6-month follow-up. We expect that EMDR plus TAU will be more effective in reducing PTSD symptoms than TAU alone. Mixed models will be conducted using an intention-to-treat and per-protocol approach.
  
  
  
  This study aims to expand the knowledge about the effectiveness of EMDR in patients with SUD and comorbid PTSD. The expected finding of the superiority of EMDR in reducing PTSD symptoms compared to non-trauma-focused PTSD treatment may enhance the use of trauma-focused treatment approaches for patients with SUD and co-morbid PTSD.
  
  
  
  German Clinical Trials Register: DRKS00009007 ; U1111-1172-9213. Retrospectively registered 01 Juni 2016.
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.|Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, University of Hamburg, Martinistr. 52, Hamburg, D-20246, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Schäfer
authors.affiliation: AHG Clinic Dormagen, Dormagen, Germany.
authors.forename: Laycen
authors.initials: L
authors.lastname: Chuey-Ferrer
authors.affiliation: EMDR-Institute Germany, Bergisch Gladbach, Germany.
authors.forename: Arne
authors.initials: A
authors.lastname: Hofmann
authors.affiliation: EMDR-Institute Germany, Bergisch Gladbach, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Lieberman
authors.affiliation: AHG Clinic Dormagen, Dormagen, Germany.
authors.forename: Günter
authors.initials: G
authors.lastname: Mainusch
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. a.lotzin@uke.de.|Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, University of Hamburg, Martinistr. 52, Hamburg, D-20246, Germany. a.lotzin@uke.de.
authors.forename: Annett
authors.identifier: 0000-0002-2834-8047
authors.initials: A
authors.lastname: Lotzin
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D015897:Comorbidity; D019317:Evidence-Based Medicine; D057169:Eye Movement Desensitization Reprocessing; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012047:Rehabilitation Centers; D016037:Single-Blind Method; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000534:rehabilitation*; D019966:Substance-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Addiction; Alcohol; Comorbidity; Exposure-based treatment; Eye movement desensitization and reprocessing; Posttraumatic stress disorder; Psychotherapy outcome research; Substance abuse; Trauma-focused treatment