Clinical and cost-effectiveness of eye movement desensitization and reprocessing for treatment and prevention of post-traumatic stress disorder in adults: A systematic review and meta-analysis

The objective was to provide up-to- date clinical and cost-effectiveness evidence investigating eye movement desensitization and reprocessing (EMDR) for treatment or prevention of adult post-traumatic stress disorder (PTSD). We conducted a systematic review of randomized controlled trials (RCTs) and cost-effectiveness studies assessing PTSD symptoms in adults, published since the NICE 2018 guidelines. EMDR was compared with trauma-focused- cognitive behavioural therapy (TF-CBT), waitlist or usual care. Six databases were searched in September 2023. Risk of bias was assessed. Data synthesis included Bayesian meta-analyses of standardized mean differences if sufficient data were available from at least three RCTs. From 2038 records, 17 studies met the eligibility criteria. One modelling-based study reported cost-effectiveness, finding EMDR the most cost-effective intervention compared to 10 others, including TF-CBT. Sixteen RCTs (n = 1031) providing clinical PTSD outcome data were identified. Most studies had small sample sizes, and all but one was at high/moderate risk of bias. Additionally, 13 RCTs from NICE 2018 guidelines contributed to meta-analyses. EMDR treatment was generally of shorter duration with a lower burden on patient time. Meta-analyses found EMDR was statistically significantly better than waitlist/usual care. There was no significant difference in treatment effect between EMDR and TF-CBT, both reported significantly improved PTSD symptoms.

Journal

English

Emma Simpson
Christopher Carroll
Anthea Sutton
Jessica Forsyth
Annabel Rayner
Shijie Ren
Matthew Franklin
Emily Wood

Simpson, E., Carrol, C., Sutton, A., Forsyth, J., Rayner, A., Ren, S., Franklin, M., & Wood, E. (2025). Clinical and cost-effectiveness of eye movement desensitization and reprocessing for treatment and prevention of post-traumatic stress disorder in adults: A systematic review and meta-analysis. British Journal of Psychology, 00, 1–22. doi:10.1111/bjop.70005