Browse > Article

A Pilot Study of Brief Eye Movement Desensitization and Reprocessing(EMDR) for Treatment of Acute Phase Schizophrenia  

Kim, Daeho (Department of Neuropsychiatry, School of Medicine, Hanyang University, and Mental Health Research Institute, Hanyang University)
Choi, Joonho (Department of Neuropsychiatry, School of Medicine, Hanyang University, and Mental Health Research Institute, Hanyang University)
Kim, Seok Hyeon (Department of Neuropsychiatry, School of Medicine, Hanyang University, and Mental Health Research Institute, Hanyang University)
Oh, Dong Hoon (Department of Neuropsychiatry, School of Medicine, Hanyang University, and Mental Health Research Institute, Hanyang University)
Park, Seon-Cheol (Department of Neuropsychiatry, School of Medicine, Hanyang University, and Mental Health Research Institute, Hanyang University)
Lee, Sun Hye (Department of Neuropsychiatry, School of Medicine, Hanyang University, and Mental Health Research Institute, Hanyang University)
Publication Information
Korean Journal of Biological Psychiatry / v.17, no.2, 2010 , pp. 94-102 More about this Journal
Abstract
Objectives : Eye movement desensitization and reprocessing(EMDR) is a novel, time-limited psychotherapy originally developed for treatment of psychological trauma. The effectiveness of this therapy has been validated only for posttraumatic stress disorder ; however, EMDR is often applied to other psychiatric illnesses, including other anxiety disorders and depression. This pilot study tested the efficacy of EMDR added to the routine treatment for individuals with acute stage schizophrenia. Methods : This study was conducted in the acute psychiatric care unit of a university-affiliated training hospital. Inpatients diagnosed with schizophrenia were randomly assigned to either three sessions of EMDR, three sessions of progressive muscle relaxation(PMR) therapy, or only treatment as usual(TAU). All the participants received concurrent typical treatments(TAU), including psychotropic medication, individual supportive psychotherapy and group activities in the psychiatric ward. The Positive and Negative Syndrome Scale(PANSS), the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale were administered by a clinical psychologist who was blinded to the patients' group assignment. Results : Forty-five patients enrolled and forty patients(89%) completed the post-treatment evaluation. There were no between-group differences in the withdrawal rates of patients during the treatment or at the three-month follow-up session. All three groups improved significantly across each of the symptomatic domains including schizophrenia, anxiety, and depressive symptoms. However, a repeated measures ANOVA revealed no significant differences among the groups over time. Effect size for change in total PANSS scores was also similar across treatment conditions, but effect size for negative symptoms was large for EMDR(0.60 for EMDR, 0.39 for PMR and 0.21 for TAU only). Conclusion : These findings supported the use of EMDR in treating the acute stage of schizophrenia but the results failed to confirm the effectiveness of the treatment over the two control conditions in three sessions. Further studies with longer courses of treatment, more focused target dimensions of treatment, and a sample of outpatients are necessary.
Keywords
Schizophrenia; Eye movement desensitization and reprocessing(EMDR); Clinical trial; Psychotherapy;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Lambert M, Schimmelmann BG, Naber D, Schacht A, Karow A, Wagner T, et al. Prediction of remission as a combination of symptomatic and functional remission and adequate subjective well-being in 2960 patients with schizophrenia. J Clin Psychiatry 2006;67:1690-1697.   DOI   ScienceOn
2 Huxley NA, Rendall M, Sederer L. Psychosocial treatments in schizophrenia: a review of the past 20 years. J Nerv Men Dis 2000;188:187-201.   DOI   ScienceOn
3 Patterson TL, Leeuwenkamp OR. Adjunctive psychosocial therapies for the treatment of schizophrenia. Schizophr Res 2008;100:108-119.   DOI
4 Bustillo J, Lauriello J, Horan W, Keith S. The psychosocial treatment of schizophrenia: an update. Am J Psychiatry 2001;158:163-175.   DOI   ScienceOn
5 Lauriello J, Bustillo J, Keith SJ. A critical review of research on psychosocial treatment of schizophrenia. Biol Psychiatry 1999;46:1409-1417.   DOI   ScienceOn
6 National Institute for Clinical Excellence: Clinical Guideline: Schizophrenia-Core Interventions in the Treatment and Management of Schizophrenia in Primary and Secondary Care. London: National Institute for Clinical Excellence; 2002.
7 Jones C, Cormac I, Silveira da Mota Neto JI, Campbell C. Cognitive behaviour therapy for schizophrenia. Cochrane Database Syst Rev 2004;(4):CD000524.
8 Marlowe K. Over-optimism of cognitive behavior therapy for schizophrenia. Am J Psychiatry 2006;163:1294.
9 Pfammatter M, Junghan UM, Brenner HD. Efficacy of psychological therapy in schizophrenia: conclusions from meta-analyses. Schizophr Bull 2006;32 Suppl 1:S64-S80.   DOI
10 Zimmermann G, Favrod J, Trieu VH, Pomini V. The effect of cognitive behavioral treatment on the positive symptoms of schizophrenia spectrum disorders: a metaanalysis. Schizophr Res 2005;77:1-9.   DOI   ScienceOn
11 Wykes T, Steel C, Everitt B, Tarrier N. Cognitive behavior therapy for schizophrenia: effect sizes, clinical models, and methodological rigor. Schizophr Bull 2008;34: 523-537.
12 Durham RC, Chambers JA, Power KG, Sharp DM, Macdonald RR, Major KA, et al. Long-term outcome of cognitive behaviour therapy clinical trials in central Scotland. Health Technol Assess 2005;9:1-174.
13 Startup M, Jackson MC, Bendix S. North Wales randomized controlled trial of cognitive behaviour therapy for acute schizophrenia spectrum disorders: outcomes at 6 and 12 months. Psychol Med 2004;34:413-422.   DOI   ScienceOn
14 Maxfiled L. Current status and future directions for EMDR research. J EMDR Res Prac 2007;1:6-14.   DOI
15 Drury V, Birchwood M, Cochrane R, Macmillan F. Cognitive therapy and recovery from acute psychosis: a controlled trial. I. Impact on psychotic symptoms. Br J Psychiatry 1996;169:593-601.   DOI   ScienceOn
16 Haddock G, Tarrler N, Morrlson AP, Hopkins R, Drake R, Lewis S. A pilot study evaluating the effectiveness of individual inpatient cognitive-behavioural therapy in early psychosis. Soc Psychiatry Psychiatr Epidemiol 1999;34: 254-258.   DOI   ScienceOn
17 Lewis S, Tarrier N, Haddock G, Bentall R, Kinderman P, Kingdon D, et al. Randomised controlled trial of cognitivebehavioural therapy in early schizophrenia: acutephase outcomes. Br J Psychiatry Suppl 2002;43:s91-s97.
18 Bae H, Kim D, Park YC. Eye Movement desensitization and reprocessing for adolescent depression. Psychiatry Investing 2008;5:60-65.   DOI   ScienceOn
19 Brown KW, McGoldrick T, Buchanan R. Body dysmorphic disorder: Seven cases treated with eye movement desensitization and reprocessing. Behav Cogn Psychother 1997;25:203-207.   DOI
20 van Etten ML, Taylor S. Comparative efficacy of treatment for posttraumatic stress disorder: a meta-analysis. Clin Psychol Psychother 1998;5:126-144.   DOI   ScienceOn
21 First MB, Gibbon M, Spitzer RL, Williams BW. Structured Clinical Interview for DSM-IV Axis I Disorders, research version. New York: Biometric Research;1996.
22 Kay SR. Positive and negative syndrome in schizophrenia: assessment and research. Vol 5. New York: Brunner/ Mazed;1991.
23 Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23:56-62.   DOI
24 Hamilton M. The assessment of anxiety states by rating. Br J Med Psychol 1959;32:50-55.   DOI   ScienceOn
25 Frueh BC, Grubaugh AL, Cusack KJ, Kimble MO, Elhai JD, Knapp RG. Exposure-based cognitive-behavioral treatment of PTSD in adults with schizophrenia or schizoaffective disorder: a pilot study. J Anxiety Disord 2009;23:665-675.   DOI   ScienceOn
26 Bernstein DA, Borkovec TD. Progressive Relaxation Training. Champaign, IL: Research Press;1973.
27 Kay S, Fiszbein A, Opler LA. The positive and negative syndrome scale(PANSS) for schizophrenia. Schizophr Bull 1987;13:261-276.   DOI   ScienceOn
28 Jackson HJ, McGorry PD, Killackey E, Bendall S, Allott K, Dudgeon P, et al. Acute-phase and 1-year follow- up results of a randomized contolled trial of CBT versus Befriending for first-episode psychosis: the ACE project. Psychol Med 2008;38:725-735.
29 Munro SL, Baker JA, Playle J. Cognitive behaviour therapy within acute mental health care: a critical appraisal. Int J Ment Health Nurs 2005;14:96-102.   DOI   ScienceOn
30 Shapiro F. Eye Movement Desensitization and Reprocessing( EMDR) and the anxiety disorders: clinical and research implications of an integrated psychotherapy treatment. J Anxiety Disord 1999;13:35-67.   DOI   ScienceOn
31 Carlson JG, Chemtob CM, Rusnak K, Hedlund NL, Muraoka MY. Eye movement desensitization and reprocessing( EDMR) treatment for combat-related posttraumatic stress disorder. J Trauma Stress 1998;11:3-24.   DOI   ScienceOn