Rolling Julie, Fath Morgane, Zanfonato Thomas, Durpoix Amaury, Mengin Amaury C, Schröder Carmen M
Department of Child and Adolescent Psychiatry, Strasbourg University Hospital, BP 426, 67091 Strasbourg, France.
Regional Center for Psychotrauma Great East, Strasbourg University Hospital, BP 426, 67091 Strasbourg, France.
Healthcare (Basel). 2024 Oct 6;12(19):1993. doi: 10.3390/healthcare12191993.
: Mental healthcare for children and adolescents with a history of childhood abuse constitutes a major public health issue. Indeed, abuse exposes children to severe and complex post-traumatic stress disorder (cPTSD) but also to neurodevelopmental and psychological repercussions impacting the developmental trajectory. Trauma-focused care is essential to avoid the chronicization of symptoms and disorders. : The aim of this prospective case series study was to investigate the efficacy of eye movement desensitization and reprocessing (EMDR) on complex post-traumatic symptoms and associated psychiatric disorders in adolescents with a history of abuse. : Twenty-two adolescents, aged 12 to 17, who had been abused during childhood were included. All adolescents met ICD-11 criteria for complex PTSD. Subjective measures of PTSD and associated psychiatric disorders were taken before (T0) and after 3 months of EMDR therapy (T1). : The average PTSD symptom score on the CPTS-RI significantly decreased from 40.2 to 34.4 after EMDR, indicating improvement in post-traumatic symptoms. A significant decrease in the average depression score (CDI from 18.2 at T0 to 10.6 at T1), anxiety score (R-CMAS from 21.3 at T0 to 13.3 at T1), emotional regulation score (ALS from 29 at T0 to 10.8 at T1), insomnia score (ISI from 18.5 at T0 to T1 of 9.2 at T1), and harmful use of alcohol and drugs score (ADOSPA from 2.3 at T0 to 0.3 at T1) was observed after EMDR therapy, as well as an increase in quality of life (CBCL 4-16 score from 57.9 at T0 to 77.4 at T1). : The results of this study are encouraging and suggest that EMDR may be effective in the symptom management reducing post-traumatic symptoms and certain comorbid disorders frequently seen in adolescents who have experienced childhood abuse. Further research is needed on adolescent populations suffering from cPTSD (e.g., randomized controlled trials with control groups and other therapies or evaluating the action of the different phases of the study).
对于有童年虐待史的儿童和青少年而言，心理保健是一个重大的公共卫生问题。事实上，虐待会使儿童面临严重且复杂的创伤后应激障碍（复杂性创伤后应激障碍），还会对其神经发育和心理产生影响，进而波及发育轨迹。以创伤为重点的护理对于避免症状和疾病的慢性化至关重要。
本前瞻性病例系列研究的目的是调查眼动脱敏再处理疗法（EMDR）对有虐待史青少年的复杂性创伤后症状及相关精神障碍的疗效。
研究纳入了22名年龄在12至17岁、童年期受过虐待的青少年。所有青少年均符合国际疾病分类第11版（ICD - 11）中复杂性创伤后应激障碍的标准。在进行EMDR治疗前（T0）和治疗3个月后（T1），对创伤后应激障碍及相关精神障碍进行主观测量。
EMDR治疗后，CPTS - RI上的创伤后应激障碍症状平均得分从40.2显著降至34.4，表明创伤后症状有所改善。EMDR治疗后，平均抑郁得分（CDI从T0时的18.2降至T1时的10.6）、焦虑得分（R - CMAS从T0时的21.3降至T1时的13.3）、情绪调节得分（ALS从T0时的29降至T1时的10.8）、失眠得分（ISI从T0时的18.5降至T1时的9.2）以及酒精和药物有害使用得分（ADOSPA从T0时的2.3降至T1时的0.3）均显著下降，生活质量（CBCL 4 - 16得分从T0时的57.9升至T1时的77.4）也有所提高。
本研究结果令人鼓舞，表明EMDR在症状管理方面可能有效，可减轻创伤后症状以及在有童年虐待经历的青少年中常见的某些共病障碍。对于患有复杂性创伤后应激障碍的青少年人群，还需要进一步研究（例如，设置对照组和其他疗法的随机对照试验，或评估研究不同阶段的作用）。
