Meentken Maya G, van der Mheen Malindi, van Beynum Ingrid M, Aendekerk Elisabeth W C, Legerstee Jeroen S, van der Ende Jan, Del Canho Riwka, Lindauer Ramón J L, Hillegers Manon H J, Moll Henriette A, Helbing Wim A, Utens Elisabeth M W J
Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands.
Department of Pediatrics, division of Cardiology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands.
Eur J Psychotraumatol. 2020 Jan 10;11(1):1705598. doi: 10.1080/20008198.2019.1705598. eCollection 2020.
: Paediatric illness, injury and medical procedures are potentially traumatic experiences with a range of possible negative psychosocial consequences. To prevent psychosocial impairment and improve medical adherence, evidence-based psychotherapy should be offered if indicated. Eye movement desensitization and reprocessing (EMDR) has been found to reduce symptoms of posttraumatic stress disorder (PTSD) in adults. The evidence for the use with children is promising. Furthermore, recent studies indicate its effectiveness for the treatment of other psychological symptomatology. However, the effectiveness of EMDR in children with subthreshold PTSD after medically related trauma has not yet been investigated. : Investigating the short-term effectiveness of EMDR on posttraumatic stress, anxiety, depression and sleep problems in children with subthreshold PTSD after hospitalization through a randomized controlled trial (RCT). : Following baseline screening of 420 children from various Dutch hospitals, 74 children (4-15 years old) with medically related subthreshold PTSD were randomized to EMDR ( = 37) or care-as-usual (CAU; = 37). Follow-up assessment took place after = 9.7 weeks. Generalized Estimating Equation (GEE) analyses were performed to examine the effectiveness of EMDR compared to CAU. : Children in both groups improved significantly over time on all outcomes. However, the EMDR group improved significantly more as to child-reported symptoms of blood-injection-injury (BII) phobia and depression, and child-, and parent-reported sleep problems of the child. There was no superior effect of EMDR compared to CAU on subthreshold PTSD symptom reduction. : EMDR did not perform better than CAU in reducing PTSD symptoms in a paediatric sample of children with subthreshold PTSD after hospitalization. However, the study results indicate that EMDR might be superior in reducing symptoms of blood-injection-injury phobia, depression and sleep problems.
儿科疾病、损伤及医疗程序都可能是创伤性经历,会带来一系列可能的负面心理社会后果。为预防心理社会功能受损并提高医疗依从性,如有指征应提供循证心理治疗。眼动脱敏再处理疗法(EMDR)已被证实可减轻成人创伤后应激障碍(PTSD)的症状。其用于儿童的证据很有前景。此外,近期研究表明其对治疗其他心理症状也有效。然而,EMDR在与医疗相关创伤后亚阈值PTSD儿童中的有效性尚未得到研究。
通过一项随机对照试验(RCT)研究EMDR对住院后亚阈值PTSD儿童创伤后应激、焦虑、抑郁及睡眠问题的短期有效性。
在对荷兰多家医院的420名儿童进行基线筛查后,74名(4至15岁)与医疗相关的亚阈值PTSD儿童被随机分为EMDR组(n = 37)或常规护理组(CAU;n = 37)。在9.7周后进行随访评估。采用广义估计方程(GEE)分析来检验EMDR与CAU相比的有效性。
两组儿童在所有结局指标上均随时间显著改善。然而,EMDR组在儿童报告的血液 - 注射 - 损伤(BII)恐惧症和抑郁症状,以及儿童和家长报告的儿童睡眠问题方面改善更为显著。与CAU相比,EMDR在减轻亚阈值PTSD症状方面没有更优效果。
在住院后亚阈值PTSD儿童的儿科样本中,EMDR在减轻PTSD症状方面并不比CAU更好。然而,研究结果表明EMDR在减轻血液 - 注射 - 损伤恐惧症、抑郁和睡眠问题症状方面可能更具优势。