Effectiveness of eye movement desensitization and reprocessing (EMDR) for trauma-related psychological disorders in disaster and epidemic settings: A systematic review

Abstract

Natural disasters and epidemics frequently result in significant psychological trauma, including post-traumatic stress disorder (PTSD) and depression, particularly among affected populations with limited access to mental health services. Eye movement desensitization and reprocessing (EMDR) has been proposed as an effective trauma-focused intervention; however, evidence regarding its effectiveness in disaster and epidemic contexts remains heterogeneous. The aim of this systematic review was to summary the available evidence on the effectiveness of EMDR in reducing trauma-related psychological disorders among disaster- and epidemic-affected populations. A systematic search of PubMed, Scopus, and SciLit was conducted on March 5, 2024, following PRISMA guidelines. Randomized controlled trials involving disaster- or epidemic-exposed populations treated with EMDR were included. Comparators comprised other traditional cognitive behavioral therapies, treatment as usual, or delayed treatment. Primary outcomes included validated trauma and PTSD instruments (Impact of Event Scale–Revised (IES-R), Post-traumatic Stress Disorder Checklist–Civilian Version (PCL-C), Post-traumatic Stress Disorder Checklist for DSM-5 (PCL-5), International Trauma Questionnaire (ITQ), and the Parent Report of Post-traumatic Symptoms. Risk of bias was assessed using the Cochrane Risk of Bias 2.0. Six studies out 1,802 identified studies were included involving 813 participants (approximately 75% female; age range of 10–58 years). EMDR was consistently associated with clinically and statistically significant reductions in trauma symptoms. Following EMDR treatment, IES-R scores decreased significantly among the disaster-affected individual. EMDR led to significant reductions in ITQ scores and PCL-C scores compared with usual care. Among adolescents affected by natural disaster, EMDR reduced Chinese version of IES-R scores significantly demonstrating superiority over treatment as usual. EMDR also showed comparable reductions across PTSD, anxiety, and depressive symptom measures compared with cognitive behavioral therapy (CBT). Treatment timing (early versus delayed EMDR) did not substantially affect outcomes. Overall risk of bias was low to moderate. In conclusion, EMDR is an effective and feasible intervention for reducing trauma-related psychological symptoms in disaster- and epidemic-affected populations. EMDR represents a valuable component of post-disaster mental health response strategies, although further large-scale comparative trials are warranted.