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1. Besson, J., Eap, C., Khazaal, Y., Montagrin, Y., Rihs-Middel, M., Simon, O., Tissot, H., Tomei, A., Zumwald, C., Zullino, D. (2008, Janvier). Dépendances [Addictions]. Revue Medicale Suisse, 4(139).

Language: French

Format: Journal

Abstract:
Cette année, les commentaires de la toxicomanie met en évidence cinq aspects, dans une perspective bio-psycho-sociale: (1) La relation entre la méthadone et de cardiotoxicité. (2) L'introduction de la désensibilisation des mouvements oculaires et retraitement (EMDR). (3) L'apparition d'une pharmacothérapie possible spécifique pour le jeu excessif. (4) Une meilleure connaissance de la relation entre le cannabis et les psychoses. (5) La résistance au traitement dans la relation médecin-patient.

This year reviews on the addictions emphasizes five aspects, on a bio-psycho-social perspective: (1) The relationship between methadone and cardiotoxicity. (2) The introduction of Eye Movement Desensibilization and Reprocessing (EMDR). (3) The apparition of a possible specific pharmacotherapy for excessive gambling. (4) A better knowledge of the relationship between cannabis and psychoses. (5) Resistance to treatment in the doctor-patient relationship.

Keywords: Addiction  Cadiotoxicity  Cannabis  Gambling  Methadone  Psychoses  

Accuracy Verified: Yes


2. de Bont, P. (2011, August-September). Efficacy and safety of prolonged exposure or EMDR-treatment for PTSD with patients with a vulnerability for psychosis. A multiple baserate N=10 single case design. In Treating PTSD in patients with psychotic disorders. Symposium conducted at the 41st EABCT annual congress, Reykjavík, Iceland.

Language: English

Format: Conference

Abstract:
Objectives: Untill now, only a small number of studies have investigated the safety and effects of psychological treatment for PTSD in psychotic patients. The main aim of this study was to explore the effects of two psychological, highly manualized, guideline PTSD treatments: EMDR and prolonged exposure. Another important aim was to determine if negative side effects would occur as a result of therapy. Among clinicians fear exists of harming vulnerable patients with confronting therapeutic procedures, thus risking psychotic exacerbation, suicidal behaviour or other adverse events. Methods: In a N=10 single case study design the effects of psychological PTSD treatment were studied in psychiatric patients who suffer from psychoses. Participants were randomly assigned to either EMDR or Prolonged Exposure. Weekly measurements of PTSD and psychotic symptoms prior to, during and after treatment, gave a strong impression of how symptoms respond to treatment. The treatment in both conditions consisted of 12 sessions of 90 minutes. Adverse events were monitored weekly. Before, directly after and 3 months after treatment all subjects were tested more extensively for the variables PTSD and psychosis, and for three secondary outcome measures cognitive style, social functioning and quality of life. Results: The results show that PTSD-treatment can be quite effective for both PTSD and even some of the psychotic symptoms. PTSD symptoms dropped considerably, in a number of cases below the point of still having a PTSD. In some cases treatment helped diminish the occurence of harming voices. Not one patient became psychotic as a result of therapy, not even patients that went through the guided reliving of traumatic psychotic events during Prolonged Exposure. No suicide attempts occured. Occasional minor adverse events with medication occurred, but results taken as a whole the treatments were obviously safe. Conclusion: This study shows that PTSD-treatment in psychotic patients is a serious option, next to medical treatment. It can be done safely, effectively and in a manualized fashion. No information can be derived from this study as to which of the two, Prolonged Exposure or EMDR, can be best applied in specific situations. Both seem to be equal in the limited number of cases.

Keywords: PE  Prolonged Exposure  Psychotic Disorders  Single Case Design  Symposium  

Accuracy Verified: Yes


3. van den Berg, D., & Staring, T. (2011, April). EMDR bij patiënten met psychosen, wie durft? [EMDR in patients with psychosis, who dares?]. Presentatie op de 5e jaarlijkse conferentie van EMDR Vereniging.

Language: Dutch

Format: Conference

Abstract:
Patiënten met psychosen hebben vaak ernstige trauma’s meegemaakt. PTSS is bij hen een van de meest voorkomende co-morbide stoornissen. De meeste therapeuten hanteren een psychotische stoornis echter als contra-indicatie voor EMDR. Tijdens deze presentatie tonen wij dat EMDR ondanks psychotische problematiek gewoon kan worden toegepast en dat dit slechts minimale aanpassingen vergt. Wij zetten daarna uiteen wat de verschillende toepassingsgebieden bij deze doelgroep zijn. EMDR kan namelijk niet alleen veilig en effectief toegepast worden bij psychosen met co-morbide PTSS, het kan ook een belangrijke rol hebben binnen CGT bij stemmen en wanen. Traumatische (leer)ervaringen zijn immers vaak betrokken bij het ontstaan van wanen en hallucinaties. Daarnaast liet recent onderzoek zien dat niet alleen retrospectieve targets behandeld kunnen worden met EMDR, maar ook situaties in de toekomst, de zogenoemde ‘flash forwards’. Dit is nuttig voor patiënten die herhaaldelijk geconfronteerd worden met stemmen of met situaties waarin paranoide gedachten worden getriggerd. Videomateriaal wordt getoond om de presentatie te ondersteunen. Tot slot is er aandacht voor obstakels in de toepassing van EMDR bij deze doelgroep. Aan het einde is er ruimte voor vragen en discussie.

Patients with psychoses often experienced severe trauma. PTSD is with them one of the most common co-morbid disorders. Most therapists use a psychotic disorder but as a contraindication to EMDR. During this presentation we demonstrate that EMDR despite psychotic problems can easily be applied and that it requires only minimal adjustments. We then set out what the different application of this target group. EMDR can not safely and effectively used in psychoses with co-morbid PTSD, it can also have an important role in CBT for voices and delusions. Traumatic (learning) experiences are often involved in the pathogenesis of delusions and hallucinations. In addition, recent studies showed that not only retrospective targets can be treated with EMDR, but also situations in the future, called "flash forwards". This is useful for patients who are repeatedly confronted with situations in which voices or paranoid thoughts are triggered. Video material is shown to support the presentation. Finally, consideration of obstacles in the application of EMDR with that audience. At the end there is room for questions and discussion.

Keywords: Pyschosis  

Accuracy Verified: Yes


4. van den Berg, D. P. G., van der Vleugel, B., & Staring, A. (2010, December). Trauma, psychose, PTSS en de toepassing van EMDR [Trauma, psychosis, PTSD and the use of EMDR]. Directieve Therapie, 30(4), 303-328. doi:10.1007/s12433-010-0242-9.

Language: Dutch

Format: Journal

Abstract:
In dit artikel beschrijven wij drie interacties tussen trauma, psychose en PTSS: 1. Veel patiënten met psychosen hebben in hun leven traumatiserende ervaringen meegemaakt. Deze traumata spelen vaak een belangrijke rol in hun psychosen en in het ontstaan hiervan. 2. Het meemaken van een psychose en de psychiatrische behandeling zijn voor veel patiënten levensechte en traumatische ervaringen, die kunnen leiden tot posttraumatische stressklachten. 3. Vaak komen psychosen en een posttraumatische stressstoornis gezamenlijk voor, waarbij er sprake is van negatieve wederzijdse beïnvloeding en voortgaande traumatisering. Deze drie interacties hebben een hoge klinische relevantie. Er is in de praktijk van de zorg voor patiënten met psychosen echter weinig aandacht voor traumatisering en comorbide PTSS. Eye Movement Desensitization and Reprocessing (EMDR) is een behandelmethode die effectief is bij de behandeling van traumata en PTSS. Wij beschrijven per genoemde interactie een behandeling waarbij EMDR is ingezet. Daarna bespreken wij een aantal factoren die een EMDRbehandeling bij patiënten met psychosen kunnen bemoeilijken, zoals doorlopende traumatisering door psychotische klachten, cognitieve beperkingen, moeite met oogbewegingen, belemmeringen door antipsychotische medicatie en verminderde affectieve expressie. Wij sluiten het artikel af met het advies om in de zorg voor mensen met psychosen aandacht te hebben voor trauma en comorbide PTSS, en patiënten hier ook voor te behandelen.

In this article we describe three interactions between trauma, psychosis and PTSD: 1. Many patients suffering from psychosis have been traumatized. This trauma often plays an important role in their psychosis and the onset thereof. 2. Having a psychosis and being treated in a psychiatric hospital are traumatic experiences for a lot of patients, and can lead to posttraumatic stress symptoms; and 3. Often psychoses and post-traumatic stress disorder occur jointly, reciprocally influencing one another and leading to ongoing traumatization. These interactions have a great clinical relevance. In the practice of care for patients with psychosis however there is little attention for traumatization and co-morbid PTSD. EMDR is a treatment approach that is effective in treating traumas and PTSD. Per interaction mentioned above we describe a treatment in which EMDR was used. After this we discuss certain factors that may complicate an EMDR treatment in patients with psychosis, such as ongoing traumatization by psychotic symptoms, cognitive impairments, difficulty with eye movements, barriers due to antipsychotic medication, and diminished emotional expression. We end the article with the advise to be aware of the high prevalence of trauma and co-morbid PTSD in the care for patients with psychosis and to treat patients for these complaints.

Keywords: Posttraumatic Stress Disorder  Psychosis  PTSD  Trauma  

Accuracy Verified: Yes