Comparison Of Eye Movement Desensitization And Reprocessing (Emdr) And Duloxetine Treatment Outcomes İn Women Patients With Somatic Symptom Disorder
Somatic symptom disorder (SSD) is a debilitating disorder that significantly diminishes quality of life and causes psychological distress such as anxiety and depression. The paper explored the efficiency of the eye movement desensitization and reprocessing (EMDR) therapy in SSD. The current investigation is a clinical trial investigating the effectiveness of eye movement desensitization (EMDR) therapy in the treatment of 31 first-diagnosed SSD patients in comparison to age, education and marital status matched 31-first-diagnosed SSD patients who received duloxetine over a 6-week course of treatment. Somatization subscale of the Symptom Checklist-Revised 90 (SCL-90), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Short Form Health Survey (SF-36) were administered to the participants. EMDR group showed enhanced improvement relative to baseline after 6 weeks of treatment compared to duloxetine group. We concluded that EMDR appears to be a highly promising therapy and should be considered among the first-line interventions in the treatment of SSD. Given that no single treatment has proven outperform another treatment for a single subtype of somatic symptom disorders, it has been suggested that the selection and intensity of the intervention should be drawn from the severity and complexity of the disorder (Schroder et al., 2012). Three groups of antidepressants are particularly considered in pharmacological interventions relevant to somatic disorders. These antidepressants are tricyclic antidepressants (TCAs; e.g., amitriptyline, desimipramine, trimipramine, doxepine, opipramol), selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, escitalopram, sertraline, paroxetine, fluvoxamine or fluoxetine), and selective serotonin and norepinephrine reuptake inhibitors (SNRIs; e.g. venlafaxine, duloxetine) (Kleinstauber et al., 2015). Systematic reviews of treatment interventions in somatic disorders have consistently concluded that nonpharmacological approaches such as psychotherapy appear to be more effective than pharmacological treatments (Hauser, Bernardy, Arnold, Offenbacher, & Schiltenwolf, 2009; Henningsen, Zipfel, & Herzog, 2007; Wulsin, 2014). Recent conceptualizations of pain place importance on the processes taking place in the brain, i.e. cortical reorganization, cognitive and motivation factors (Flor, 2002; Flor, Denke, Schaefer, & Grusser, 2001; Karl, Muhlnickel, Kurth, & Flor, 2004; Price, 2000; Turk, 2003). Of note is the fact that affective component of the noniceptive sensations has not been sufficiently taken into account in the previous models of chronic pain (Ray & Zbik, 2001). More recent models hold the premise that the role of the emotion is central in the genesis and maintenance of chronic pain and in turn suggest that treatment should be tailored in a manner addressing the emotional component of noniceptive sensations (Price, 2000; Rome & Rome, 2000; Schneider, Hofmann, Rost, & Shapiro, 2007; van Rood & de Roos, 2009). Eye movement desensitization and reprocessing (EMDR) is built on the adaptive information processing (AIP) model, which posits that prior affect-laden traumatic experiences result in various patterns of symptoms such as flashbacks, physical sensations and chronic pain (Shapiro, 2001). In accordance with the extant literature of pain (Ray & Zbik, 2001; Rome & Rome, 2000), the AIP model prospects that particularly chronic pain is related to past traumatic experiences, which is assumed to be limbically augmented during the sensitization process (Shapiro, 2014). More importantly, in review of the literature strong evidence with respect to the utilization of EMDR in the treatment of chronic pain has been emerged (Bergmann, 1998; Grant, 1998; Grant & Threlfo, 2002; Schneider et al., 2007; Schneider, Hofmann, Rost, & Shapiro, 2008). The focus of the current study was to compare the effectiveness of EMDR and duloxetine in the treatment of patients with somatic symptom disorder. It was hypothesized that painful memories are the antecedents of limbically augmented somatic symptomatology, in which EMDR can be used to reprocess and change somatic reactions to emotionally charged memories linked to somatization. The trial involved 62 first-time-diagnosed patients with somatic symptom disorder (SSD) consecutively admitted to the psychiatry clinics of Yüzüncü Yıl University Training and Education Hospital and Bağcılar Training and Education Hospital due to the medically unexplained physical symptoms.
For full text:http://www.sleepandhypnosis.org/ing/Pdf/812cd16c840e461792b598887f38e100.pdf
For full text:http://www.sleepandhypnosis.org/ing/Pdf/812cd16c840e461792b598887f38e100.pdf
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