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眼动脱敏与再处理综合团体治疗方案(EMDR-IGTP)应用于痴呆患者照料者

Eye Movement Desensitization and Reprocessing Integrative Group Treatment Protocol (EMDR-IGTP) Applied to Caregivers of Patients With Dementia.

作者信息

Passoni Serena, Curinga Teresa, Toraldo Alessio, Berlingeri Manuela, Fernandez Isabel, Bottini Gabriella

机构信息

Cognitive Neuropsychology Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.

EMDR Italy Association, Varedo, Italy.

出版信息

Front Psychol. 2018 Jun 15;9:967. doi: 10.3389/fpsyg.2018.00967. eCollection 2018.

Abstract

Caregivers of patients with dementia experience high levels of stress and burden, with effects comparable to those of a traumatic event. Eye Movement Desensitization and Reprocessing (EMDR) appear to be effective in recovering post-traumatic stress disorder (PTSD). We aimed at investigating the effectiveness of the Eye Movement Desensitization and Reprocessing Integrative Group Treatment Protocol (EMDR-IGTP) on the "caregiver syndrome". Forty-four primary caregivers entered the study. They were randomly assigned to either the "immediate" branch, who received the treatment soon after recruitment, or to the "delayed" branch, who received it two months after recruitment. The treatment consisted of eight group sessions (one per week) spanning over two months. Emotional distress was measured before the treatment, immediately after the end of it, and two months later (follow-up), by means of several clinical scales (Impact of Event Scale-Revised, IES-R; Caregiver Needs Assessment, CNA; Caregiver Burden Inventory, CBI; Anxiety and Depression Scale-Reduced Form, AD-R). The "immediate" branch improved significantly more than the "delayed" (control) branch on The Impact of Event Scale-Revised, the Anxiety, and the Depression scales; however, after treatment such an improvement was maintained only in the first scale. The "delayed" branch took less advantage of the treatment, showing significant reduction only on the Depression scale, an effect which disappeared at follow-up. These preliminary results show for the first time that EMDR-IGTP reduces stress-related symptoms, anxiety, and depression in caregivers of patients with dementia. Interestingly, caregivers who were inserted in a waiting list after recruitment showed smaller treatment effects. Larger samples are needed to better interpret such differential clinical profiles.

摘要

痴呆症患者的照料者承受着高水平的压力和负担,其影响与创伤性事件相当。眼动脱敏再处理疗法(EMDR)似乎对创伤后应激障碍(PTSD)的恢复有效。我们旨在研究眼动脱敏再处理综合团体治疗方案(EMDR-IGTP)对“照料者综合征”的有效性。44名主要照料者参与了该研究。他们被随机分配到“立即”组,即在招募后不久接受治疗,或“延迟”组,在招募两个月后接受治疗。治疗包括为期两个月、每周一次共八次的团体治疗课程。通过几种临床量表(事件影响量表修订版,IES-R;照料者需求评估量表,CNA;照料者负担量表,CBI;焦虑抑郁量表简化版,AD-R)在治疗前、治疗结束后立即以及两个月后(随访)测量情绪困扰。在事件影响量表修订版、焦虑量表和抑郁量表上,“立即”组的改善明显大于“延迟”(对照组)组;然而,治疗后这种改善仅在第一个量表上得以维持。“延迟”组从治疗中获益较少,仅在抑郁量表上显示出显著降低,且这种效果在随访时消失。这些初步结果首次表明,EMDR-IGTP可减轻痴呆症患者照料者的压力相关症状、焦虑和抑郁。有趣的是,招募后被列入等候名单的照料者治疗效果较小。需要更大的样本量来更好地解释这种不同的临床特征。

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