Eye movement desensitization and reprocessing (EMDR) is a well-established treatment for post-traumatic stress disorder. Recent research suggested that it may be effective in treating depressive disorders as well. The present study is part of a multicenter randomized-controlled trial, the EDEN study, in which a homogenous group of 30 patients was treated to test whether EMDR plus treatment as usual (TAU) would achieve superior results compared to TAU only in a psychosomatic-psychotherapeutic inpatient treatment setting. Both groups were assessed by the Beck Depression Inventory-II (BDI-II) and the Global Severity Index and depression subscale of the Symptom Checklist 90-Revised. The EMDR + TAU group improved significantly better than the TAU group on the BDI-II and Global Severity Index, while a marginally significant difference favoring the EMDR + TAU group over the TAU group was found on the depression subscale. In the EMDR + TAU group, seven out of 14 patients improved below nine points on the BDI-II, which is considered to be a full remission, while four out of 16 in the TAU group did so. These findings confirm earlier suggestions that EMDR therapy may provide additional benefit in the treatment of depression. The present study strengthens the previous literature on EMDR therapy in the treatment of depression due to the randomized-controlled design of the EDEN study.
Post-traumatic stress disorder (PTSD) is diagnosed in 3% of German and 14–16% of US military following deployment abroad. The treatment of PTSD in soldiers is often challenging and thus new, additional interventions supporting traditional trauma therapy are employed, like animal-assisted interventions (AAI). In this pilot study, 29 soldiers with PTSD received four sessions of 3 h once a week of dog-assisted intervention in addition to inpatient standard treatment at the military hospital, while the control group of 31 soldiers with PTSD received standard treatment only. The dog-assisted intervention sessions included a walk, different play and grooming activities and just relaxing together toward the end. What was new in our approach was that the AAI sessions were delivered by military personnel, military dog-handlers with their own dogs (either military or privately owned). Data on psychiatric symptoms, perceived stress, work and social life, and the therapeutic relationship were answered before the first AAI session, during the days following the last AAI session, 1 month later, and 3 months later. Only the intervention group also answered a questionnaire on trauma confrontation, consumption of alcohol/drugs, mental wellness, and perceived stress each week during intervention. Analyses showed a trend for worse values in work and social adjustment in the control group and a significant trend toward better values in the intervention group. On the other parameters differences between control and intervention group were not significant. The mental wellness of the intervention group improved over the 4 weeks of therapy, particularly regarding the ability to experience joy. There was no clear trend for perceived stress, but the relationship to the dog handler improved significantly over the course of the intervention. This is noteworthy in patients with PTSD who usually have difficulties trusting others, especially new people. Keeping in mind that the AAI took place only four times, our findings point toward the value of dog-assisted interventions. With a longer treatment period the positive effects and trends might become more distinct.
The data from this pilot study show an obvious connection between PTSD and orofacial dysfunctions. Through further prospective studies it should be evaluated if there is a general vulnerability of those afflicted for pathological orofacial stress. This could be used for screening before combat deployment.
Objectives The aim of a pilot study was to clarify the question of whether mouth opening restrictions in patients with PTSD by means of splint therapy (st) show long-term therapeutic effects in the case of functional disorders. Material and methods In 31 of 36 inpatients (soldiers, average age 37.1 ± 7.3 years, 26.7 ± 2.1 teeth) with confirmed posttraumatic stress disorder, chronic pain intensity > 6 (visual analogue scale 0 to 10), the mouth opening was determined, and the functional status (RDC-TMD) was recorded. All participants received a splint that was worn at night. A control of the therapeutic effect of the splint occurred after 6 weeks, 3, 6, and 12 months. Results The mouth opening initially had an average of 30.9 ± 6.5 mm (median 31 mm). The pain intensity (PI) was reported to be on average VAS 8.3 ± 0.9, the chronic degree of pain according to von Korff was 3.9 ± 03. Six weeks after the st (n = 31), the average mouth opening was 49.5 ± 6.3 mm (median 51.5). PI was given as VAS 2.3 ± 1.1 on average. After 3, 6, and 12 months, 24, 15, and 14 subjects could be interviewed regarding PI. Based on the last examination date of all subjects, the average PI was given as 1.1 ± 0.9 (median 1). Conclusion The presented data show that the therapeutic short-term results achieved by means of a splint remain valid on the long term despite continued PTSD. Clinical relevance The presented study shows that patients will benefit in the long term from a splint and remain symptom-free, even if this mental illness persists.
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