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眼动脱敏再处理治疗脑卒中后创伤后应激障碍:采用三相法的病例报告。

Eye movement desensitization and reprocessing for post-stroke post-traumatic stress disorder: Case report using the three-phase approach.

机构信息

Department of Psychology, University of Victoria, Victoria, Canada.

出版信息

Brain Inj. 2022 Dec 6;36(12-14):1372-1381. doi: 10.1080/02699052.2022.2140833. Epub 2022 Nov 13.

Abstract

Medically-induced post-traumatic stress disorder (PTSD) is substantially more prevalent than PTSD in the general population. In people with stroke, it can impact as many as 23% of patients, with negative effects on mental health as well as stroke-related disability. Medically-induced PTSD may have unique features compared to other forms of PTSD, and therefore there is a pressing need to evaluate existing treatments for PTSD in this context. The current study reports on the feasibility, safety, and efficacy of Eye Movement Desensitization and Reprocessing (EMDR) for PTSD subsequent to a pontine stroke. Using a quasi-experimental case design, a 44-year-old Caucasian woman received EMDR delivered via telehealth. Self-report measures were obtained at baseline, pre-EMDR, and post-EMDR, with brief neuropsychological testing pre/post-EMDR. After 3 sessions of EMDR, the patient no longer met criteria for PTSD, and showed clinically significant reductions in depressive and generalized anxiety symptoms. With proper safety provisions, it is feasible to deliver EMDR via telehealth to alleviate post-stroke PTSD. Reduced linguistic demands of EMDR may be particularly appealing for persons with neurological disorders as compared to other trauma therapies. Further work is also needed to understand the parameters of baseline neuropsychological function that could impact response to intervention.

摘要

医源性创伤后应激障碍(PTSD)的发病率明显高于普通人群中的 PTSD。在中风患者中,多达 23%的患者会受到影响,这会对心理健康和中风相关残疾产生负面影响。与其他形式的 PTSD 相比,医源性 PTSD 可能具有独特的特征,因此迫切需要在这种情况下评估现有的 PTSD 治疗方法。本研究报告了眼动脱敏再处理(EMDR)治疗桥脑中风后 PTSD 的可行性、安全性和疗效。采用准实验性病例设计,一名 44 岁的白人女性接受了远程医疗提供的 EMDR。在基线、EMDR 前和 EMDR 后采集自我报告测量值,并在 EMDR 前后进行简短的神经心理学测试。经过 3 次 EMDR 治疗后,患者不再符合 PTSD 标准,抑郁和广泛性焦虑症状也有了明显的临床改善。在适当的安全措施下,通过远程医疗提供 EMDR 以减轻中风后 PTSD 是可行的。与其他创伤疗法相比,EMDR 对语言要求较低,可能对神经障碍患者特别有吸引力。还需要进一步研究以了解可能影响干预反应的基线神经心理学功能参数。

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