Journal of Korean Medical Science

Korean Acad Medical Sciences (대한의학회)
권호 표지
DOI QR코드

DOI QR Code

Add-on Eye Movement Desensitization and Reprocessing (EMDR) Therapy for Adults with Post-traumatic Stress Disorder Who Failed to Respond to Initial Antidepressant Pharmacotherapy

  • Bae, Hwallip (Workplace Mental Health Institute, Gangbuk Samsung Medical Center) ;
  • Kim, Daeho (Department of Psychiatry, College of Medicine, Hanyang University) ;
  • Cho, Yubin (Department of Psychiatry, College of Medicine, Hanyang University) ;
  • Kim, Dongjoo (Department of Psychiatry, College of Medicine, Hanyang University) ;
  • Kim, Seok Hyeon (Department of Psychiatry, College of Medicine, Hanyang University)
  • Received : 2018.04.26
  • Accepted : 2018.08.27
  • Published : 2018.11.29
⟨ Previous Next ⟩

Abstract

This study examined the add-on efficacy of eye movement desensitization and reprocessing (EMDR) therapy among adult civilians with post-traumatic stress disorder (PTSD) who continued to be symptomatic after more than 12 weeks of initial antidepressant treatment. Scores for the Clinician Administered PTSD Scale (CAPS) were rated pre- and post-EMDR and at a 6-month follow-up. After an average of six sessions of EMDR treatment, seven of 14 patients (50%) showed more than a 30% decrease in CAPS score and eight (57%) no longer met the criteria for PTSD. Our results indicate that EMDR could be successfully added after failure of initial pharmacotherapy for PTSD.

Keywords

Acknowledgement

Supported by : Ministry of Health and Welfare

References

  1. Lee DJ, Schnitzlein CW, Wolf JP, Vythilingam M, Rasmusson AM, Hoge CW. Psychotherapy versus pharmacotherapy for posttraumatic stress disorder: systemic review and meta-analyses to determine first-line treatments. Depress Anxiety 2016;33(9):792-806. https://doi.org/10.1002/da.22511
  2. World Health Organization. WHO Guidelines on Conditions Specifically Related to Stress. Geneva: World Health Organization; 2013.
  3. Cohen BE, Shi Y, Neylan TC, Maguen S, Seal KH. Antipsychotic prescriptions in Iraq and Afghanistan veterans with posttraumatic stress disorder in Department of Veterans Affairs healthcare, 2007-2012. J Clin Psychiatry 2015;76(4):406-12. https://doi.org/10.4088/JCP.13m08857
  4. Nobles CJ, Valentine SE, Zepeda ED, Ahles EM, Shtasel DL, Marques L. Usual course of treatment and predictors of treatment utilization for patients with posttraumatic stress disorder. J Clin Psychiatry 2017;78(5):e559-66. https://doi.org/10.4088/JCP.16m10904
  5. Brady K, Pearlstein T, Asnis GM, Baker D, Rothbaum B, Sikes CR, et al. Efficacy and safety of sertraline treatment of posttraumatic stress disorder: a randomized controlled trial. JAMA 2000;283(14):1837-44. https://doi.org/10.1001/jama.283.14.1837
  6. Davidson JR, Rothbaum BO, van der Kolk BA, Sikes CR, Farfel GM. Multicenter, double-blind comparison of sertraline and placebo in the treatment of posttraumatic stress disorder. Arch Gen Psychiatry 2001;58(5):485-92. https://doi.org/10.1001/archpsyc.58.5.485
  7. Campanini RF, Schoedl AF, Pupo MC, Costa AC, Krupnick JL, Mello MF. Efficacy of interpersonal therapy-group format adapted to post-traumatic stress disorder: an open-label add-on trial. Depress Anxiety 2010;27(1):72-7. https://doi.org/10.1002/da.20610
  8. Hinton DE, Chhean D, Pich V, Safren SA, Hofmann SG, Pollack MH. A randomized controlled trial of cognitive-behavior therapy for Cambodian refugees with treatment-resistant PTSD and panic attacks: a cross-over design. J Trauma Stress 2005;18(6):617-29. https://doi.org/10.1002/jts.20070
  9. Hinton DE, Pham T, Tran M, Safren SA, Otto MW, Pollack MH. CBT for Vietnamese refugees with treatment-resistant PTSD and panic attacks: a pilot study. J Trauma Stress 2004;17(5):429-33. https://doi.org/10.1023/B:JOTS.0000048956.03529.fa
  10. Otto MW, Hinton D, Korbly NB, Chea A, Ba P, Gershuny BS, et al. Treatment of pharmacotherapy-refractory posttraumatic stress disorder among Cambodian refugees: a pilot study of combination treatment with cognitive-behavior therapy vs sertraline alone. Behav Res Ther 2003;41(11):1271-6. https://doi.org/10.1016/S0005-7967(03)00032-9
  11. Rothbaum BO, Cahill SP, Foa EB, Davidson JR, Compton J, Connor KM, et al. Augmentation of sertraline with prolonged exposure in the treatment of posttraumatic stress disorder. J Trauma Stress 2006;19(5):625-38. https://doi.org/10.1002/jts.20170
  12. Shapiro F. Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures, 3rd ed. New York, NY: The Guilford Press; 2017.
  13. Farrell D. EMDR therapy in the treatment of a Hillsborough survivors with posttraumatic stress disorder. J Pers Inj Law. Forthcoming 2018.
  14. Farrell D. The neurobiology of eye movement desensitization reprocessing therapy. In: Beech AR, Carter AJ, Mann RE, Rotshtein P, editors. The Wiley Blackwell Handbook of Forensic Neuroscience, 1st ed. Hoboken, NJ: John Wiley & Sons; 2018, 755-81.
  15. First MB, Williams JB, Spitzer RL, Gibbon M. Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Clinician Version. (SCID-CV). New York, NY: Biometrics Research, New York State Psychiatric Institute; 2007.
  16. Blake DD, Weathers FW, Nagy LM, Kaloupek DG, Gusman FD, Charney DS, et al. The development of a clinician-administered PTSD scale. J Trauma Stress 1995;8(1):75-90. https://doi.org/10.1002/jts.2490080106
  17. Lee BY, Kim Y, Yi SM, Eun HJ, Kim DI, Kim JY. A reliability and validity study of a clinician administered PTSD scale. J Korean Neuropsychiatr Assoc 1999;38(3):514-22.
  18. Bae H, Kim D, Park YC. Dissociation predicts treatment response in eye-movement desensitization and reprocessing for posttraumatic stress disorder. J Trauma Dissociation 2016;17(1):112-30. https://doi.org/10.1080/15299732.2015.1037039
  19. Ipser JC, Stein DJ. Evidence-based pharmacotherapy of post-traumatic stress disorder (PTSD). Int J Neuropsychopharmacol 2012;15(6):825-40. https://doi.org/10.1017/S1461145711001209
  20. Weathers FW, Keane TM, Davidson JR. Clinician-administered PTSD scale: a review of the first ten years of research. Depress Anxiety 2001;13(3):132-56. https://doi.org/10.1002/da.1029
  21. Rodrigues H, Figueira I, Goncalves R, Mendlowicz M, Macedo T, Ventura P. CBT for pharmacotherapy non-remitters--a systematic review of a next-step strategy. J Affect Disord 2011;129(1-3):219-28. https://doi.org/10.1016/j.jad.2010.08.025
  22. Nijdam MJ, Gersons BP, Reitsma JB, de Jongh A, Olff M. Brief eclectic psychotherapy v. eye movement desensitisation and reprocessing therapy for post-traumatic stress disorder: randomised controlled trial. Br J Psychiatry 2012;200(3):224-31. https://doi.org/10.1192/bjp.bp.111.099234
  23. Londborg PD, Hegel MT, Goldstein S, Goldstein D, Himmelhoch JM, Maddock R, et al. Sertraline treatment of posttraumatic stress disorder: results of 24 weeks of open-label continuation treatment. J Clin Psychiatry 2001;62(5):325-31. https://doi.org/10.4088/JCP.v62n0503
  24. Jeffreys M, Capehart B, Friedman MJ. Pharmacotherapy for posttraumatic stress disorder: review with clinical applications. J Rehabil Res Dev 2012;49(5):703-15. https://doi.org/10.1682/JRRD.2011.09.0183
  25. van der Kolk BA, Spinazzola J, Blaustein ME, Hopper JW, Hopper EK, Korn DL, et al. A randomized clinical trial of eye movement desensitization and reprocessing (EMDR), fluoxetine, and pill placebo in the treatment of posttraumatic stress disorder: treatment effects and long-term maintenance. J Clin Psychiatry 2007;68(1):37-46. https://doi.org/10.4088/JCP.v68n0105
  26. Watts BV, Shiner B, Zubkoff L, Carpenter-Song E, Ronconi JM, Coldwell CM. Implementation of evidence-based psychotherapies for posttraumatic stress disorder in VA specialty clinics. Psychiatr Serv 2014;65(5):648-53. https://doi.org/10.1176/appi.ps.201300176

Cited by

  1. The MET(T)A Protocol: Mindfulness and EMDR Treatment Template for Agencies vol.14, pp.None, 2020, https://doi.org/10.1177/1178221820977483