Eye Movement Desensitization and Reprocessing for Posttraumatic Stress Disorder in Bipolar Disorder

Abstract

There is evidence that posttraumatic stress disorder (PTSD) is more prevalent in patients with bipolar disorder. According to a review,1 the mean prevalence of PTSD in bipolar patients is 16.0%, which is double the lifetime prevalence of PTSD in the general population.2 Also bipolar patients with comorbid PTSD exhibit more severe bipolar illness and multiple Axis I disorders, and they disengage more frequently from treatment, suggesting poorer outcome and course of the disorder.3,4 Trauma-focused cognitive-behavior therapy and eye movement desensization and reprocessing (EMDR) are considered first-line treatments for PTSD.5 Nonetheless, evidence for the efficacy of PTSD treatment in bipolar disorder is lacking. This is an unsatisfactory situation given the fact that antidepressant pharmacotherapy, often suggested as a second-line treatment for PTSD, has limited application for for bipolar patients because of the possibility of manic switch and adverse long-term outcomes.6 We report here the successful administration of EMDR to two cases of PTSD in patients with bipolar disorder.