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眼动脱敏与再处理疗法治疗公共交通工作者慢性创伤后应激障碍——一项随机对照试验

On treatment with eye movement desensitization and reprocessing of chronic post-traumatic stress disorder in public transportation workers--a randomized controlled trial.

作者信息

Högberg Göran, Pagani Marco, Sundin Orjan, Soares Joaquim, Aberg-Wistedt Anna, Tärnell Berit, Hällström Tore

机构信息

Department of Clinical Neuroscience, Section for Psychiatry, Huddinge, Karolinska Institutet, Stockholm, Sweden.

出版信息

Nord J Psychiatry. 2007;61(1):54-61. doi: 10.1080/08039480601129408.

Abstract

Previous studies on post-traumatic stress disorder (PTSD) investigated a variety of treatments and included mostly patients victims of sexual and combat assault. This study aimed to determine the short-term efficacy of eye movement desensitization and reprocessing (EMDR) in occupation-based PTSD. Employees of the public transportation system in Stockholm, who had been experiencing a person-under-train accident or had been assaulted at work were recruited. Subjects with trauma exposure since more than 3 months but less than 6 years were included. Twenty-four subjects who fulfilled the DSM-IV criteria for PTSD were randomized to either EMDR therapy (n=13) or waiting list (WL, n=11). They were assessed pre-treatment and shortly after completion of treatment or WL period. The pre-defined primary outcome variable was full PTSD diagnosis. Secondary outcome variables were the results of various psychometric scales. Twelve participants began and completed five sessions of EMDR and nine completed the WL. After therapy, eight subjects in the EMDR group (67%) and one (11%) in WL did not fulfil the criteria for PTSD diagnosis (difference, P=0.02). Among the secondary outcome variables, there were significant differences post-treatment between the groups EMDR/WL in Global Assessment of Function (GAF) score and Hamilton Depression (HAM-D) score. This study indicates that EMDR has a short-term effect on PTSD in public transportation workers exposed to occupational traumatic events. Such intensive and brief therapy might be further validated in larger samples of exposed workers with longer periods of follow-up.

摘要

以往关于创伤后应激障碍(PTSD)的研究调查了多种治疗方法,且大多纳入了性侵犯和战斗攻击的受害者患者。本研究旨在确定眼动脱敏再处理疗法(EMDR)对职业性PTSD的短期疗效。招募了斯德哥尔摩公共交通系统中经历过列车撞人事故或在工作中遭受攻击的员工。纳入创伤暴露时间超过3个月但少于6年的受试者。24名符合DSM-IV PTSD标准的受试者被随机分为EMDR治疗组(n = 13)或等待名单组(WL,n = 11)。在治疗前以及治疗结束后或等待名单期结束后不久对他们进行评估。预先定义的主要结局变量是PTSD的完全诊断。次要结局变量是各种心理测量量表的结果。12名参与者开始并完成了5次EMDR治疗,9名完成了等待名单期。治疗后,EMDR组中有8名受试者(67%),等待名单组中有1名受试者(11%)不符合PTSD诊断标准(差异,P = 0.02)。在次要结局变量中,EMDR组与等待名单组在治疗后全球功能评估(GAF)得分和汉密尔顿抑郁量表(HAM-D)得分方面存在显著差异。本研究表明,EMDR对遭受职业创伤事件的公共交通工作人员的PTSD有短期疗效。这种密集且简短的治疗方法可能需要在更大样本的暴露工人中进行更长时间的随访以进一步验证。

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