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      Dessensibilização e reprocessamento por movimentos oculares (EMDR) para transtorno de estresse pós- traumático: uma revisão sistemática Translated title: Eye movement desensitization and reprocessing (EMDR) for posttraumatic stress disorder: a systematic review

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          Abstract

          A Dessensibilização e Reprocessamento Através de Movimentos Oculares (Eye Movement Desensitization and Reprocessing - EMDR) é um meio de tratamento para o Transtorno de Estresse Pós-Traumático (TEPT). Esta técnica se baseia em uma ativação das memórias traumáticas com a ajuda dos estímulos bilaterais proporcionando um processamento adequado dessas memórias. Apesar de existirem estudos de meta-análise sobre a técnica, algumas lacunas ainda são apontadas na literatura. Este estudo consiste em uma revisão sistemática que objetiva atender a tais lacunas, além de prover um breve resumo sobre o protocolo de aplicação do EMDR, tendo em vista a escassez de material publicado sobre o assunto no Brasil. O presente estudo conclui que pesquisas clínicas controladas e de follow up (seguimento) reforçam a evidência de eficácia do EMDR em comparação com outras técnicas e de que os seus efeitos se mantêm por pelo menos tanto tempo quanto em outras formas de terapia

          Translated abstract

          Eye Movement Desensitization and Reprocessing (EMDR) is a treatment technique for Posttraumatic Stress Disorder (PTSD). This technique is based on an activation of traumatic memories with the help of bilateral stimuli providing a proper processing of these memories. Although meta-analysis of the technique are available, some gaps are still reported in literature. This study consists of a systematic review that aims at addressing these gaps and, in addition, providing a brief summary as to the application of the EMDR protocol since there is little published material on the subject. This study concluded that randomized clinical trials and follow up studies support the evidence that EMDR is efficient compared with other techniques and that the effects of EMDR remain for at least as long as other forms of therapy

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          Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample.

          Timothy A Brown, Laura A Campbell, Cassandra L. Lehman … (2001)
          The comorbidity of current and lifetime DSM-IV anxiety and mood disorders was examined in 1,127 outpatients who were assessed with the Anxiety Disorders Interview Schedule for DSM-IV: Lifetime version (ADIS-IV-L). The current and lifetime prevalence of additional Axis I disorders in principal anxiety and mood disorders was found to be 57% and 81%, respectively. The principal diagnostic categories associated with the highest comorbidity rates were mood disorders, posttraumatic stress disorder (PTSD), and generalized anxiety disorder (GAD). A high rate of lifetime comorbidity was found between the anxiety and mood disorders; the lifetime association with mood disorders was particularly strong for PTSD, GAD, obsessive-compulsive disorder, and social phobia. The findings are discussed in regard to their implications for the classification of emotional disorders.
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            A multidimensional meta-analysis of psychotherapy for PTSD.

            Rebekah Bradley, Jamelle Greene, Eric Russ … (2005)
            The authors present a multidimensional meta-analysis of studies published between 1980 and 2003 on psychotherapy for PTSD. Data on variables not previously meta-analyzed such as inclusion and exclusion criteria and rates, recovery and improvement rates, and follow-up data were examined. Results suggest that psychotherapy for PTSD leads to a large initial improvement from baseline. More than half of patients who complete treatment with various forms of cognitive behavior therapy or eye movement desensitization and reprocessing improve. Reporting of metrics other than effect size provides a somewhat more nuanced account of outcome and generalizability. The majority of patients treated with psychotherapy for PTSD in randomized trials recover or improve, rendering these approaches some of the most effective psychosocial treatments devised to date. Several caveats, however, are important in applying these findings to patients treated in the community. Exclusion criteria and failure to address polysymptomatic presentations render generalizability to the population of PTSD patients indeterminate. The majority of patients posttreatment continue to have substantial residual symptoms, and follow-up data beyond very brief intervals have been largely absent. Future research intended to generalize to patients in practice should avoid exclusion criteria other than those a sensible clinician would impose in practice (e.g., schizophrenia), should avoid wait-list and other relatively inert control conditions, and should follow patients through at least 2 years.
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              Cognitive therapy for post-traumatic stress disorder: development and evaluation.

              Ann Hackmann, Anke Ehlers, Michael Clark … (2005)
              The paper describes the development of a cognitive therapy (CT) program for post-traumatic stress disorder (PTSD) that is based on a recent cognitive model (Behav. Res. Therapy 38 (2000) 319). In a consecutive case series, 20 PTSD patients treated with CT showed highly significant improvement in symptoms of PTSD, depression and anxiety. A subsequent randomized controlled trial compared CT (N = 14) and a 3-month waitlist condition (WL, N = 14). CT led to large reductions in PTSD symptoms, disability, depression and anxiety, whereas the waitlist group did not improve. In both studies, treatment gains were well maintained at 6-month follow-up. CT was highly acceptable, with an overall dropout rate of only 3%. The intent-to-treat effect sizes for the degree of change in PTSD symptoms from pre to post-treatment were 2.70-2.82 (self-report), and 2.07 (assessor-rated). The controlled effect sizes for CT versus WL post-treatment scores were 2.25 (self-report) and 2.18 (assessor-rated). As predicted by the cognitive model, good treatment outcome was related to greater changes in dysfunctional post-traumatic cognitions. Patient characteristics such as comorbidity, type of trauma, history of previous trauma, or time since the traumatic event did not predict treatment response, however, low educational attainment and low socioeconomic status were related to better outcome.
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                Author and article information

                Journal
                Journal ID (publisher-id): gerais
                Title: Gerais : Revista Interinstitucional de Psicologia
                Abbreviated Title: Gerais, Rev. Interinst. Psicol.
                Publisher: Universidade Federal de São João del-Rei, Universidade Federal de Minas Gerais e Universidade Federal de Uberlândia. (Belo Horizonte, MG, Brazil )
                ISSN (Electronic): 1983-8220
                Publication date (Print and electronic): June 2014
                Volume: 7
                Issue: 1
                Pages: 119-131
                Affiliations
                [01] Porto Alegre orgnamePontifícia Universidade Católica do Rio Grande do Sul Brasil
                Article
                Publisher ID: S1983-82202014000100011 Publisher ID: S1983-8220(14)00700100011
                SO-VID: 5b9227ac-1863-462c-a9c2-8d862db32288
                License:

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                Date received : 14 May 2012
                Date accepted : 27 February 2013
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 64, Pages: 13
                Product

                SciELO Periódicos Eletrônicos em Psicologia

                Categories
                Subject: Revisões críticas de literatura

                Keywords: Posttraumatic Stress Disorder,Systematic Review,Dessensibilização e Reprocessamento por Movimentos Oculares,Transtorno de Estresse Pós-Traumático,Revisão sistemática,Eye Movement Desensitization and Reprocessing
                Data availability:
                Keywords: Posttraumatic Stress Disorder, Systematic Review, Dessensibilização e Reprocessamento por Movimentos Oculares, Transtorno de Estresse Pós-Traumático, Revisão sistemática, Eye Movement Desensitization and Reprocessing

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