{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T10:19:23Z","timestamp":1787221163523,"version":"build-2736575974"},"reference-count":38,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T00:00:00Z","timestamp":1748476800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aims<\/jats:title><jats:p>Post\u2010traumatic stress disorder (PTSD) and substance use disorder (SUD) are highly co\u2010occurring and evidence for the optimal ways of treating PTSD in SUD patients is mixed. Our aim was to compare three different PTSD treatments, each added simultaneously to SUD treatment, with SUD treatment alone in patients with co\u2010occurring SUD\u2010PTSD. These PTSD treatments were: Prolonged Exposure (PE), Eye Movement Desensitization and Reprocessing (EMDR) and Imagery Rescripting (ImRs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A single\u2010blind 4\u2010arm randomized controlled trial with follow\u2010up at 3\u00a0months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Two addiction treatment centers in the Netherlands, providing intra\u2010 and extramural care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>209 patients with SUD and co\u2010morbid PTSD were included [mean age 37.5 (standard deviation, SD\u2009=\u200911.99), female sex\u2009=\u200946.4%, mean Clinically Administered PTSD Scale (CAPS) score\u2009=\u200937.35 (SD\u2009=\u20099.28)].<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>Participants were randomized to either simultaneous SUD\u2009+\u2009PE (<jats:italic>n<\/jats:italic>\u2009=\u200953), SUD\u2009+\u2009EMDR (<jats:italic>n<\/jats:italic>\u2009=\u200950), SUD\u2009+\u2009ImRs (<jats:italic>n<\/jats:italic>\u2009=\u200955) or to SUD treatment only (<jats:italic>n<\/jats:italic>\u2009=\u200951), with the active PTSD treatments consisting of 12 sessions each within 3\u00a0months. Standard protocols were used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>The primary outcome was clinician\u2010administered PTSD symptom severity as measured by Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (CAPS\u20105) at 3\u00a0month follow\u2010up. Secondary outcomes included loss of PTSD diagnosis, full remission of PSTD and SUD\u2010severity, also recorded at 3\u00a0months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Compared with SUD only, the mean differences in CAPS\u20105 score were B\u2009=\u2009\u22125.41 [95% confidence interval (CI) = 10.88, 0.05, <jats:italic>P<\/jats:italic>\u2009=\u20090.052] for SUD\u2009+\u2009PE, B\u2009=\u2009\u22127.97 (95% CI = \u221213.57, \u22122.37, <jats:italic>P<\/jats:italic>\u2009=\u20090.006) for SUD\u2009+\u2009EMDR and B\u2009=\u2009\u221210.03 (95% CI = \u221215.29, \u22124.77, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) for SUD\u2009+\u2009ImRs. When adjusted for baseline covariates, mean differences were B\u2009=\u2009\u22125.81 (95% CI = \u221211.48, \u22120.15, <jats:italic>P<\/jats:italic>\u2009=\u20090.044) for SUD\u2009+\u2009PE, B\u2009=\u2009\u20108.85 (95% CI = \u221214.60, \u22123.10, <jats:italic>P<\/jats:italic>\u2009=\u20090.003) for SUD\u2009+\u2009EMDR and B\u2009=\u2009\u201010.75 (95% CI = \u221215.94, \u22125.56, <jats:italic>P<\/jats:italic>\u2009=\u2009&lt;0.001) for SUD\u2009+\u2009ImRs. No between\u2010group differences in SUD outcomes were found.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Among people with co\u2010occurring substance use disorder (SUD) and post\u2010traumatic stress disorder (PTSD), trauma\u2010focused PTSD treatment as add\u2010on to SUD treatment appears to be effective in decreasing PTSD severity compared with manualized SUD only treatment and does not appear to increase SUD severity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.70097","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:50:06Z","timestamp":1748566206000},"page":"2231-2244","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Effectiveness of treating post\u2010traumatic stress disorder in patients with co\u2010occurring substance use disorder with prolonged exposure, eye movement desensitization and reprocessing or imagery rescripting: A randomized controlled trial"],"prefix":"10.1111","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0155-0496","authenticated-orcid":false,"given":"Sera","family":"Lortye","sequence":"first","affiliation":[{"name":"Arkin Mental Health Care Jellinek, Amsterdam Institute for Addiction Research  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne P.","family":"Will","sequence":"additional","affiliation":[{"name":"Arkin Mental Health Care Jellinek, Amsterdam Institute for Addiction Research  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loes A.","family":"Marquenie","sequence":"additional","affiliation":[{"name":"Arkin Mental Health Care Jellinek, Amsterdam Institute for Addiction Research  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick M.","family":"Lommerse","sequence":"additional","affiliation":[{"name":"Department of Research Arkin Mental Health Care  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Faber","sequence":"additional","affiliation":[{"name":"Arkin Mental Health Care Jellinek, Amsterdam Institute for Addiction Research  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna E.","family":"Goudriaan","sequence":"additional","affiliation":[{"name":"Arkin Mental Health Care Jellinek, Amsterdam Institute for Addiction Research  Amsterdam the Netherlands"},{"name":"Department of Psychiatry University Medical Center (UMC) \u2013University of Amsterdam  Amsterdam the Netherlands"},{"name":"Amsterdam Public Health Research Institute  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnoud","family":"Arntz","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marleen M.","family":"de Waal","sequence":"additional","affiliation":[{"name":"Arkin Mental Health Care Jellinek, Amsterdam Institute for Addiction Research  Amsterdam the Netherlands"},{"name":"Department of Psychiatry University Medical Center (UMC) \u2013University of Amsterdam  Amsterdam the Netherlands"},{"name":"Amsterdam Public Health Research Institute  Amsterdam the 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