Supplementary Material for: Eye Movement Desensitisation and Reprocessing with and without Dialectical Behaviour Therapy for Posttraumatic Stress Disorder and Comorbid Borderline Personality Disorder Symptoms: A Randomised Controlled Trial

Introduction: Comorbidity between posttraumatic stress disorder (PTSD) and borderline personality disorder (BPD) is prevalent. Despite evidence-based therapies, high rates of non-response and dropout persist. This study therefore aimed to examine whether the concurrent application of eye movement desensitization and reprocessing (EMDR) for PTSD and dialectical behavior therapy (DBT) for BPD yields better results than EMDR alone.
Methods: Patients with a PTSD diagnosis and at least four BPD symptoms were randomly assigned to EMDR (n = 63) or concurrent EMDR-DBT (n = 61). Over one year, changes in PTSD symptoms were measured using the Clinician-Administered PTSD Scale for DSM-5. Secondary outcomes included BPD symptoms, global functioning and quality of life.
Results: Both treatments led to large reductions in PTSD symptoms, without significant differences after one year (p = .312, d = -0.23, 95% CI = -0.6, 0.1). Both treatments also yielded large and comparable reductions in BPD symptoms and improved quality of life. Global functioning improved only in the EMDR condition according to one measure (WHODAS 2.0), while the other measure (OQ-45) showed improvements in both groups. Additionally, patients in the EMDR-DBT condition were twice as likely to drop out from EMDR treatment compared to those in the EMDR-only condition.
Conclusion: Stand-alone EMDR demonstrated safety and efficacy in alleviating PTSD and BPD symptoms, as well as enhancing quality of life. These findings support the use of EMDR as a strong therapeutic option for patients with PTSD and comorbid BPD symptoms. Further research is needed to assess longer-term outcomes beyond one year.

引言：创伤后应激障碍（Posttraumatic Stress Disorder, PTSD）与边缘型人格障碍（Borderline Personality Disorder, BPD）共病现象十分普遍。尽管已有循证疗法，此类患者的治疗无应答率与脱落率仍居高不下。因此本研究旨在探讨，针对PTSD采用眼动脱敏与再加工疗法（Eye Movement Desensitization and Reprocessing, EMDR）、同时针对BPD辅以辩证行为疗法（Dialectical Behavior Therapy, DBT）的联合治疗方案，是否较单纯EMDR治疗能取得更优疗效。
研究方法：将确诊PTSD且至少存在4项BPD症状的患者随机分为两组：单纯EMDR组（n=63）与EMDR-DBT联合治疗组（n=61）。研究周期为一年，采用《DSM-5版临床医师评定创伤后应激障碍量表》（Clinician-Administered PTSD Scale for DSM-5）评估PTSD症状的变化情况。次要结局指标包括BPD症状、整体功能状态与生活质量。
研究结果：两组治疗均能显著减轻PTSD症状，且一年后两组间无统计学差异（p=0.312，d=-0.23，95%置信区间[-0.6, 0.1]）。两组在BPD症状的减轻程度与生活质量改善方面均表现出显著效果，且组间无明显差异。针对整体功能状态的评估显示，仅单纯EMDR组在采用世界卫生组织残疾评定量表2.0（WHO Disability Assessment Schedule 2.0, WHODAS 2.0）时出现显著改善；而采用症状问卷45项版（Outcome Questionnaire 45, OQ-45）的评估则显示两组均有所提升。此外，EMDR-DBT联合治疗组的患者脱落风险是单纯EMDR组的两倍。
结论：单纯EMDR治疗在缓解PTSD与BPD症状、提升生活质量方面均展现出良好的安全性与有效性。本研究结果支持将EMDR作为合并BPD症状的PTSD患者的优选治疗方案。未来仍需开展长期随访研究，以评估超过一年的远期治疗结局。