Emma Children's Hospital, Amsterdam UMC, Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, University of Amsterdam, Amsterdam, The Netherlands.
Emma Children's Hospital and Amsterdam Lysosome Center "Sphinx", Amsterdam UMC, Pediatric Metabolic Diseases, University of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands.
Orphanet J Rare Dis. 2022 Sep 2;17(1):328. doi: 10.1186/s13023-022-02500-9.
Parents of children with a rare progressive life-limiting illness are at risk for parental posttraumatic stress disorder (PTSD). Studies on the treatment of parental PTSD with eye movement and desensitization reprocessing (EMDR) therapy in pediatric practice are lacking. Therefore this study aims to evaluate the feasibility and effectiveness of time-limited EMDR therapy in reducing PTSD symptoms, comorbid psychological symptoms, distress, and parental stress.
Mono-center randomized clinical trial conducted between February 2020 and April 2021. Fourteen parents (N = 7 mothers, N = 7 fathers) of mucopolysaccharidosis type III patients reporting PTSD symptoms on a (sub)clinical level were assigned to EMDR or a wait-list control condition followed by EMDR. Four sessions of EMDR (each 90 min) divided over two half-days were offered. Measurements were conducted at baseline, post-treatment/post-waitlist, and 3-months post-treatment. The primary outcome was PTSD symptom severity (PTSD Check List for DSM-5). Secondary outcomes included comorbid psychological symptoms (Brief Symptom Inventory), distress (Distress Thermometer for Parents) and parenting stress (Parenting Stress Questionnaire). Between-group comparisons pre-to-post treatment (N = 7 EMDR vs. N = 7 wait-list) and within-group comparisons (EMDR, N = 14) from pre-to-post treatment and from pre-treatment to 3-months follow-up were carried out per intent-to-treat linear mixed model analyses.
Compared to wait-list, EMDR resulted in a significant reduction on total PTSD symptom severity (d = 1.78) and on comorbid psychological symptoms, distress and parenting stress (d = .63-1.83). Within-group comparisons showed a significant effect on all outcomes at post-treatment (d = 1.04-2.21) and at 3-months follow-up (d = .96-2.30) compared to baseline. EMDR was well-tolerated, associated with a low drop-out rate, a high therapy adherence and no adverse events.
Time-limited EMDR reduces PTSD symptoms, psychological comorbidity, distress and parenting stress in parents of children with a rare progressive life-limiting illness. This treatment was feasible for these overburdened parents. Recurrent monitoring of PTSD symptoms, and, if needed, offering this time-limited type of trauma treatment should be introduced in everyday pediatric practice. Trial registration Netherlands Trial Register, NL8496. Registered 01-04-2020, https://trialsearch.who.int/Trial2.aspx?TrialID=NL8496 .
患有罕见进行性危及生命疾病的儿童的父母有患创伤后应激障碍（PTSD）的风险。在儿科实践中，关于眼动脱敏再处理（EMDR）疗法治疗父母 PTSD 的研究很少。因此，本研究旨在评估限时 EMDR 疗法在降低 PTSD 症状、共病心理症状、痛苦和父母压力方面的可行性和有效性。
这是一项在 2020 年 2 月至 2021 年 4 月期间进行的单中心随机临床试验。14 名（N=7 名母亲，N=7 名父亲）报告在临床上处于亚临床水平患有黏多糖贮积症 III 型的儿童的父母被分配到 EMDR 或等待名单对照条件下，然后进行 EMDR。提供 4 次 EMDR（每次 90 分钟），分为两个半天进行。测量在基线、治疗后/等待名单后和治疗后 3 个月进行。主要结局是 PTSD 症状严重程度（DSM-5 PTSD 检查表）。次要结局包括共病心理症状（简明症状清单）、痛苦（父母痛苦温度计）和育儿压力（父母压力问卷）。采用意向治疗线性混合模型分析，对治疗前至治疗后（N=7 EMDR 与 N=7 等待名单）和治疗前至 3 个月随访（EMDR，N=14）的组间比较和组内比较进行了比较。
与等待名单相比，EMDR 可显著降低 PTSD 症状总严重程度（d=1.78）和共病心理症状、痛苦和育儿压力（d=.63-1.83）。组内比较显示，与基线相比，所有结局在治疗后（d=1.04-2.21）和 3 个月随访时（d=.96-2.30）均有显著影响。与基线相比，EMDR 在治疗后（d=1.04-2.21）和 3 个月随访时（d=.96-2.30）均有显著影响。EMDR 耐受性良好，脱落率低，治疗依从性高，无不良反应。
限时 EMDR 可降低患有罕见进行性危及生命疾病儿童的父母的 PTSD 症状、心理共病、痛苦和育儿压力。对于这些负担过重的父母来说，这种治疗是可行的。应在日常儿科实践中引入 PTSD 症状的定期监测，如果需要，应提供这种限时创伤治疗。
荷兰试验登记处，NL8496。登记日期：2020 年 4 月 1 日，https://trialsearch.who.int/Trial2.aspx?TrialID=NL8496。
