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一项针对创伤后应激障碍的为期五天的住院眼动脱敏再处理治疗方案:初步研究。

A five-day inpatient EMDR treatment programme for PTSD: pilot study.

作者信息

Zepeda Méndez Mayaris, Nijdam Mirjam J, Ter Heide F Jackie June, van der Aa Niels, Olff Miranda

机构信息

Foundation Centrum '45 | partner in Arq Psychotrauma Expert Group, Diemen, The Netherlands.

Department of Psychiatry, Academic Medical Center at the University of Amsterdam, Amsterdam, The Netherlands.

出版信息

Eur J Psychotraumatol. 2018 Feb 5;9(1):1425575. doi: 10.1080/20008198.2018.1425575. eCollection 2018.

Abstract

: Trauma-focused psychotherapies for posttraumatic stress disorder (PTSD) have been demonstrated to be efficacious, but also have considerable non-response and dropout rates. Intensive treatment may lead to faster symptom reduction, which may contribute to treatment motivation and thereby to reduction of dropout. : The aim of the current study was to investigate the feasibility and preliminary effectiveness of an intensive five-day inpatient treatment with Eye Movement Desensitization and Reprocessing (EMDR) and trauma-informed yoga for patients with PTSD. : A non-controlled pilot study with 12 adult patients with PTSD was conducted. At baseline the PTSD diagnosis was assessed with the Clinician-Administered PTSD Scale (CAPS-5) and comorbid disorders with the Mini International Neuropsychiatric Interview (MINI). Primary outcome was self-reported PTSD symptom severity (PTSD Check List for DSM-5; PCL-5) measured at the beginning of day 1 (T1), at the end of day 5 (T2) and at follow-up on day 21 (T3). Reliable change indexes (RCI) and clinically significant changes were calculated. : From T1 to T3, PTSD symptoms significantly improved with a large effect size (Cohen's  = 0.91). Nine of the 11 patients who completed treatment showed reliable changes in terms of self-reported PTSD. At T3, two of the patients no longer met criteria for PTSD as measured with the PCL-5. One patient dropped out after the first day. No serious adverse events occurred. : The majority of patients in our pilot study experienced symptom reduction consistent with reliable changes in this five-day inpatient treatment with EMDR and yoga. Randomized controlled trials - with longer follow up periods - are needed to properly determine efficacy and efficiency of intensive clinical treatments for PTSD compared to regular treatment. This is one of the first studies to show that intensive EMDR treatment is feasible and is indicative of reliable improvement in PTSD symptoms in a very short time frame.

摘要

创伤聚焦心理疗法治疗创伤后应激障碍(PTSD)已被证明是有效的,但也有相当高的无反应率和脱落率。强化治疗可能会使症状减轻得更快,这可能有助于提高治疗动机,从而降低脱落率。本研究的目的是调查为期五天的强化住院治疗——眼动脱敏再处理疗法(EMDR)和创伤知情瑜伽——对PTSD患者的可行性和初步疗效。对12名成年PTSD患者进行了一项非对照试验性研究。在基线时,使用临床医生管理的PTSD量表(CAPS-5)评估PTSD诊断,并使用迷你国际神经精神访谈(MINI)评估共病。主要结局是在第1天开始时(T1)、第5天结束时(T2)和第21天随访时(T3)自我报告的PTSD症状严重程度(DSM-5的PTSD检查表;PCL-5)。计算可靠变化指数(RCI)和临床显著变化。从T1到T3,PTSD症状显著改善,效应量较大(科恩d = 0.91)。11名完成治疗的患者中有9名在自我报告的PTSD方面显示出可靠变化。在T3时,两名患者根据PCL-5测量不再符合PTSD标准。一名患者在第一天后退出。未发生严重不良事件。在我们的试验性研究中,大多数患者在为期五天的EMDR和瑜伽住院治疗中症状减轻,与可靠变化一致。与常规治疗相比,需要进行随访期更长的随机对照试验,以正确确定PTSD强化临床治疗的疗效和效率。这是首批表明强化EMDR治疗可行且能在极短时间内使PTSD症状可靠改善的研究之一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c3b/5804727/6969cb2bb7ae/ZEPT_A_1425575_F0001_B.jpg

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