IEPA 11

David van den Berg1, Paul de Bont2, Berber van der Vleugel3, Carlijn de Roos4, Ad de Jongh5,6, Agnes van Minnen7,8, Mark van der Gaag1,9; 1Parnassia Psychiatric Institute, The Hague, Netherlands, 2Mental Health Organisation GGZ Oost Brabant, The Netherlands, 3Community Mental Health Service GGZ Noord-Holland Noord, 4Mental Health Organisation Rivierduinen, Leiden, The Netherlands, 5Department of Behavioral Sciences, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, 6School of Health Sciences, Salford University, Manchester, UK, 7Radboud University Nijmegen, Behavioural Science Institute, NijCare, The Netherlands, 8PSYTREC Psychotrauma Expertise Center, Bilthoven, The Netherlands, 9VU University Amsterdam and EMGO Institute for Health and Care Research, Department of Clinical Psychology,
           
Background: Both childhood trauma and posttraumatic stress increase the odds of developing psychosis. Trauma focused treatments were found to reduce PTSD at 6-month follow-up in individuals who had, on average, been suffering from psychosis for 17.7 years and from PTSD for 21 years (van den Berg et al, 2015). In this RCT, participants in the control condition received their TFT of choice after the 6-month follow-up assessment. The prolonged exposure (PE) and eye movement desensitization and reprocessing (EMDR) groups were also assessed at 12-month follow-up. Methods: we compared the long-term outcomes for PE and EMDR with the 6-month outcomes to test whether the effects endured on the long term (n=85, = 78.8%). Results: Positive effects of both PE and EMDR on clinician-rated PTSD, self-rated PTSD, depression, paranoid-referential thinking, and remission from schizophrenia were maintained up to 12-month follow-up. Negative posttraumatic cognitions declined further in PE and were stable in EMDR. A significant decline in social functioning was found, whereas reductions in the interference of PTSD symptoms with social functioning were maintained. Discussion: Treating posttraumatic stress symptoms after 21 years is feasible and has long-term neutral to positive side-effects on symptoms of psychosis. Many factors other than PTSD, influence social functioning in this group and 8 sessions of therapy are not enough to enhance social recovery.  A next step is to attend to symptoms of posttraumatic stress in young people with emerging symptoms of psychosis.  As societies, we should invest more in the primary prevention of childhood trauma.