Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) have high comorbidity. Although prior research indicated that PTSD can effectively be treated with Prolonged Exposure (PE) in these patients, reported effects are small and treatment dropout rates high. Eye Movement Desensitization and Reprocessing (EMDR) and Imagery Rescripting (ImRs) are other promising treatment options for PTSD, that have not yet been examined in this patient group. Furthermore, it is unclear whether PTSD treatment is most effective when offered simultaneous to or after SUD treatment. In this article, the Treatment Of PTSD and Addiction (TOPA) study is described: a Dutch randomized controlled trial (RCT) that studies the effectiveness of PTSD treatment as an add-on to regular SUD treatment in patients with SUD and co-occurring PTSD. Effects of PE, EMDR, ImRs, and a 3-month SUD treatment only condition will be compared, as well as simultaneous SUD/PTSD treatment to sequential SUD/PTSD treatment. The primary outcome measure is PTSD symptoms. Secondary outcomes are: treatment completion, psychological distress, substance use, interpersonal problems, emotion dysregulation, and trauma-related emotions guilt, shame, and anger. This study is the first to compare effects of PE, EMDR, and ImRs in one study and to compare simultaneous SUD/PTSD treatment to sequential SUD/PTSD treatment as well. This RCT will provide more knowledge about the effectiveness of different treatment strategies for PTSD in patients with co-occurring SUD and will ultimately improve treatment outcomes for patients with this common co-morbidity worldwide. Netherlands Trial Register (NTR), Identifier: NL7885 . Registered 22 July 2019.

中文翻译：

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治疗同时发生创伤后应激障碍的物质使用障碍患者的创伤后应激障碍：比较不同类型和时间治疗的有效性的随机对照试验的研究方案


创伤后应激障碍（PTSD）和物质使用障碍（SUD）具有很高的合并症。尽管之前的研究表明，通过长期暴露（PE）可以有效治疗这些患者的创伤后应激障碍（PTSD），但报道的效果很小，而且治疗中途退出率很高。眼动脱敏和再处理 (EMDR) 和意象重写 (ImRs) 是治疗 PTSD 的其他有前景的治疗选择，但尚未在该患者组中进行检查。此外，尚不清楚在 SUD 治疗同时或之后进行 PTSD 治疗是否最有效。本文描述了 PTSD 和成瘾治疗 (TOPA) 研究：一项荷兰随机对照试验 (RCT)，研究 PTSD 治疗作为常规 SUD 治疗的补充对 SUD 和并发 PTSD 患者的有效性。将比较 PE、EMDR、ImR 和仅 3 个月 SUD 治疗条件的效果，以及同时 SUD/PTSD 治疗与序贯 SUD/PTSD 治疗的效果。主要结果指标是 PTSD 症状。次要结果是：治疗完成、心理困扰、药物使用、人际关系问题、情绪失调以及与创伤相关的情绪内疚、羞耻和愤怒。这项研究首次在一项研究中比较了 PE、EMDR 和 ImR 的效果，并比较了同步 SUD/PTSD 治疗与序贯 SUD/PTSD 治疗。该随机对照试验将提供更多关于针对同时发生 SUD 的 PTSD 患者的不同治疗策略的有效性的知识，并将最终改善全球患有这种常见共病的患者的治疗结果。荷兰试验登记册 (NTR)，标识符：NL7885。注册日期：2019 年 7 月 22 日。