• 대한불안의학회지
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• 제2권2호
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• pp.142-146
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• 2006

People who were exposed to chronic interpersonal traumas in their early life consistently demonstrate complex psychological disturbances and many of them meet the criteria for proposed diagnosis of complex posttraumatic stress disorder (complx PTSD). The author reports a case of the successful sequential integrative treatment mainly composed of eye movement desensitization and reprocessing (EMDR) in a complex PTSD patient. The patient did not respond to the previous treatment with psychotropic medications and supportive psychotherapy. Twelve sessions of EMDR and three sessions of supportive psychotherapy were done for the patient. Psychological assessments were performed before starting the treatment and a week after completing the treatment. After the treatment, the patient improved on all the psychological scales and behavioral measures. This case suggests that the sequential integrative treatment mainly composed of EMDR may be effective for complex PTSD patients.

• 생물정신의학
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• 제11권2호
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• pp.173-180
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• 2004

Over the last decade, EMDR(Eye Movement Desensitization and Reprocessing) has emerged as a promising new treatment for trauma and other anxiety-based disorders. However, neurobiological mechanism of EMDR has not been well understood. Authors report SPECT findings of two patients of PTSD before and after EMDR. Brain 99mTc-ECD-SPECT was performed before and after EMDR treatment. To evaluate the significance of changes in the regional cerebral perfusion, t-test was conducted on the resulting images using SPM99. In addition, clinical scales(CAPS, CGI, STAI) were employed to asses the changes in the clinical symptoms of the patients. After EMDR treatment, each showed significant improvement in clinical symptoms. The cerebral perfusion increased in bilateral dorsolateral prefrontal cortex, and decreased in the temporal association cortex. The differences in the cerebral perfusion between patients after treatment and normal controls decreased. These changes appeared mainly in the limbic area the and the prefrontal cortex. These results suggest that EMDR may show the therapeutic effect through 1) improvement in the emotional control by increased activity in the prefrontal cortex, 2) inhibited hyperstimuli on amygdala by deactivation of the association cortex, 3) inhibition on past trauma related memory, and 4) keeping the functional balance between the limbic area and the prefrontal cortex. This case report needs further replication from studies with larger sample.