Journal Article

Treating posttraumatic stress disorder in substance use disorder patients with co-occurring posttraumatic stress disorder: study protocol for a randomized controlled trial to compare the effectiveness of different types and timings of treatment

Arntz, Arnoud, Will, Joanne P., Goudriaan, Anna E., Lortye, Sera A., de Waal, Marleen M., Marquenie, Loes A.

2021

Overview

Background Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) have high comorbidity. Although prior research indicated that PTSD can effectively be treated with Prolonged Exposure (PE) in these patients, reported effects are small and treatment dropout rates high. Eye Movement Desensitization and Reprocessing (EMDR) and Imagery Rescripting (ImRs) are other promising treatment options for PTSD, that have not yet been examined in this patient group. Furthermore, it is unclear whether PTSD treatment is most effective when offered simultaneous to or after SUD treatment. Methods In this article, the Treatment Of PTSD and Addiction (TOPA) study is described: a Dutch randomized controlled trial (RCT) that studies the effectiveness of PTSD treatment as an add-on to regular SUD treatment in patients with SUD and co-occurring PTSD. Effects of PE, EMDR, ImRs, and a 3-month SUD treatment only condition will be compared, as well as simultaneous SUD/PTSD treatment to sequential SUD/PTSD treatment. The primary outcome measure is PTSD symptoms. Secondary outcomes are: treatment completion, psychological distress, substance use, interpersonal problems, emotion dysregulation, and trauma-related emotions guilt, shame, and anger. Discussion This study is the first to compare effects of PE, EMDR, and ImRs in one study and to compare simultaneous SUD/PTSD treatment to sequential SUD/PTSD treatment as well. This RCT will provide more knowledge about the effectiveness of different treatment strategies for PTSD in patients with co-occurring SUD and will ultimately improve treatment outcomes for patients with this common co-morbidity worldwide. Trial registration Netherlands Trial Register (NTR), Identifier: NL7885 . Registered 22 July 2019.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: addiction and impulse control / Addictions / Care and treatment / Comorbidity / Desensitization (Psychology) / Drug abuse / Drug addiction / Drug use / Eye movement desensitization and reprocessing / Eye Movement Desensitization Reprocessing / Humans / Imagery rescripting / Intervention / Management / Medicine / Medicine & Public Health / Methods / Morbidity / Patients / Post traumatic stress disorder / Prolonged exposure / Psychiatry / Psychotherapy / Randomized Controlled Trials as Topic / Stress Disorders, Post-Traumatic - complications / Stress Disorders, Post-Traumatic - epidemiology / Stress Disorders, Post-Traumatic - therapy / Study Protocol / Substance abuse / Substance abuse treatment / Substance use disorder / Substance-related disorders / Substance-Related Disorders - complications / Substance-Related Disorders - therapy / Testing / Trauma / Treatment Outcome / Treatment timing