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眼动脱敏与再处理疗法与认知行为疗法治疗成人创伤后应激障碍的系统评价与荟萃分析

Eye movement desensitization and reprocessing versus cognitive-behavioral therapy for adult posttraumatic stress disorder: systematic review and meta-analysis.

作者信息

Chen Ling, Zhang Guiqing, Hu Min, Liang Xia

机构信息

*School of Medicine and †Departments of Rehabilitation and Psychology, the First Affiliated Hospital of School of Medicine, Shihezi University, Shihezi, China.

出版信息

J Nerv Ment Dis. 2015 Jun;203(6):443-51. doi: 10.1097/NMD.0000000000000306.


DOI:10.1097/NMD.0000000000000306
PMID:25974059
Abstract

Posttraumatic stress disorder (PTSD) is a relatively common mental disorder, with an estimated lifetime prevalence of ∼5.7%. Eye movement desensitization and reprocessing (EMDR) and cognitive-behavioral therapy (CBT) are the most often studied and most effective psychotherapies for PTSD. However, evidence is inadequate to conclude which treatment is superior. Therefore, we conducted a meta-analysis to confirm the effectiveness of EMDR compared to CBT for adult PTSD. We searched Medline, PubMed, Ebsco, Proquest, and Cochrane (1989-2013) to identify relevant randomized control trials comparing EMDR and CBT for PTSD. We included 11 studies (N = 424). Although all the studies had methodological limitations, meta-analyses for total PTSD scores revealed that EMDR was slightly superior to CBT. Cumulative meta-analysis confirmed this and a meta-analysis for subscale scores of PTSD symptoms indicated that EMDR was better for decreased intrusion and arousal severity compared to CBT. Avoidance was not significantly different between groups. EMDR may be more suitable than CBT for PTSD patients with prominent intrusion or arousal symptoms. However, the limited number and poor quality of the original studies included suggest caution when drawing final conclusions.

摘要

创伤后应激障碍(PTSD)是一种相对常见的精神障碍,估计终生患病率约为5.7%。眼动脱敏再处理疗法(EMDR)和认知行为疗法(CBT)是针对PTSD研究最频繁且最有效的心理疗法。然而,尚无足够证据断定哪种治疗方法更具优势。因此,我们进行了一项荟萃分析,以证实与CBT相比,EMDR对成人PTSD的有效性。我们检索了Medline、PubMed、Ebsco、Proquest和Cochrane数据库(1989年至2013年),以确定比较EMDR和CBT治疗PTSD的相关随机对照试验。我们纳入了11项研究(N = 424)。尽管所有研究都存在方法学上的局限性,但对PTSD总分的荟萃分析显示,EMDR略优于CBT。累积荟萃分析证实了这一点,对PTSD症状子量表分数的荟萃分析表明,与CBT相比,EMDR在减轻侵入性症状和唤醒严重程度方面效果更好。两组之间在回避方面无显著差异。对于具有明显侵入性或唤醒症状的PTSD患者,EMDR可能比CBT更合适。然而,纳入的原始研究数量有限且质量较差,因此在得出最终结论时应谨慎。

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