Eye Movement Desensitization and Reprocessing (EMDR) for the treatment of psychosis: a systematic review

Abstract

Background: Psychosis is a public health concern. There is increasing evidence suggesting trauma can play a pivotal role in the development and maintenance of psychosis. Eye Movement Desensitization and Reprocessing (EMDR) is an effective treatment for trauma and could be a vital addition to the treatment of psychosis. Objective: To explore the evidence for EMDR as a treatment for psychosis, focussing on the safety, effectiveness and acceptability of this intervention for this population. Methods: Four databases (Cochrane, EMBASE, MEDLINE PsychINFO), and the Francine Shapiro Library were systematically searched, along with grey literature and reference lists of relevant papers. No date limits were applied as this is an area of emerging evidence. Studies were screened for eligibility based on inclusion and exclusion criteria. The included studies were quality assessed and data was extracted from the individual studies, and synthesized using a narrative synthesis approach. Results: Six studies met the inclusion criteria (1 RCT, 2 Pilot studies, 2 Case series and 1 Case report). Across the studies EMDR was associated with reductions in delusional and negative symptoms, mental health service and medication use. Evidence for reductions in auditory hallucinations and paranoid thinking was mixed. No adverse events were reported, although initial increases in psychotic symptoms were observed in two studies. Average dropout rates across the studies were comparable to other trauma-focused treatments for PTSD. The acceptability of EMDR was not adequately measured or reported. Conclusion: EMDR appears a safe and feasible intervention for people with psychosis. The evidence is currently insufficient to determine the effectiveness and acceptability of the intervention for this population. Larger confirmative trials are required to form more robust conclusions.

Remission of schizophrenia after an EMDR session

“…While we found evidence in the literature of the effectiveness on psychotic symptoms of trauma-focused therapies (Van den Berg et al, 2018 ; Adams, Ohlsen, & Wood, 2020 ), we did not find any mention of the complete remission of schizophrenia with a discontinuation of all psychotropic treatment without relapse over 18 months.…”

“…Among these, EMDR has shown its therapeutic effects in psychosis: it has no adverse effects, is associated with a reduction in delusional and negative symptoms, a reduction in the need for care and a reduction in the prescription of psychotropic drugs. (Adams et al, 2020 ; Van den Berg et al, 2018 ).…”

“…This case study demonstrates the need to look for a history of trauma but also the existence of dissociation in all patients who are involved in psychiatric care. A more systematic consideration of the traumatic dimension of psychotic disorders would reveal a double diagnostic but also therapeutic interest, as so far, trauma-focused therapies have had a positive impact on all psychotic symptoms (Adams et al, 2020 ; Van den Berg et al, 2018 ).…”

Psychotherapy for Phantom Limb Pain

“…Eye movement desensitization and ongoing treatment is a new comprehensive psychotherapy technique [24]. It is widely used in the field of veterans [26] and psychosis [27]. It has achieved very good curative effect in the treatment of PTSD.…”

Psychosis, trauma and dissociation: evolving perspectives on severe psychopathology Psychosis, trauma and dissociation: evolving perspectives on severe psychopathology , edited by Andrew Moskowitz PhD, Martin J. Dorahy PhD, Ingo Schäfer MD, MPH, Hoboken, NJ: John Wiley & Sons, 2018, $66.78 (Hardcover) pp 455; Print ISBN:9781119952855, Online ISBN:9781118585948

“…Some chapters are also dedicated to describing psychological approaches to understand and treat psychosis and related experiences including the Maastricht Approach (Chapter 24) to understand voice-hearing, the Eye Movement Desensitization and Reprocessing (EMDR) therapy to treat individuals with psychosis and PTSD (Chapter 25), and the psychodynamic approach (Chapter 26). The efficacy of the latter is yet to be backed by empirical evidence, but a recent systematic review has endorsed the safety and feasibility of EMDR for psychosis (Adams, Ohlsen, & Wood, 2020 ). Other trauma-focused treatments (e.g.…”