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How do clients experience intensive EMDR for post-traumatic stress? An interpretative phenomenological analysis 客户如何体验针对创伤后应激反应的强化 EMDR?解释现象学分析
IF 2 Q3 PSYCHIATRY Pub Date : 2024-10-31 DOI: 10.1016/j.ejtd.2024.100479
Sarah-Jane Butler , Christine Ramsey-Wade

Background

Several studies of the intensive delivery of Eye Movement Desensitization and Reprocessing (EMDR) have indicated it to be an effective treatment for Post-Traumatic Stress Disorder (PTSD), providing improved client experience, faster reduction in symptoms, greater symptom reduction, and reduced dropout rates as compared to non-intensive EMDR. However, there is a dearth of studies that describe this non-traditional approach to the delivery of EMDR psychotherapy from the patients’ perspective.

Procedure

This qualitative study explores the experiences of patients who undertook intensive EMDR for post-traumatic stress. Interviews were conducted with 10 participants and analysed using Interpretative Phenomenological Analysis (IPA).

Main findings

The data revealed two Personal Experiential Themes (PET) and four experiential statements. ‘The importance of psychological safety’ generated sub-themes of ‘A protected space’ and ‘The importance of a continued connection’. ‘The changing self’ generated two sub-themes of a ‘Wow! moment’, and ‘Living the way I always wanted’.

Conclusion

Results show that intensive EMDR can be experienced as safe, facilitating agency and engagement while affecting meaningful change.
背景多项关于眼动脱敏与再处理(EMDR)强化治疗的研究表明,EMDR是治疗创伤后应激障碍(PTSD)的有效方法,与非强化EMDR相比,EMDR能改善患者体验、更快地减轻症状、更大程度地减轻症状以及降低辍学率。本定性研究探讨了接受强化EMDR治疗创伤后应激障碍的患者的经历。研究对 10 名参与者进行了访谈,并采用解释性现象学分析法(IPA)对访谈结果进行了分析。心理安全的重要性 "产生了 "受保护的空间 "和 "持续联系的重要性 "两个次主题。改变中的自我 "产生了 "哇!的时刻 "和 "以我一直想要的方式生活 "两个次主题。
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引用次数: 0
The effectiveness of Reconsolidation of Traumatic Memories for Complex PTSD – A pilot quasi-experimental study from a wellness centre in India 重新整合创伤记忆对复杂创伤后应激障碍的疗效--印度一家健康中心的试点准实验研究
IF 2 Q3 PSYCHIATRY Pub Date : 2024-10-31 DOI: 10.1016/j.ejtd.2024.100480
Gunjan Y Trivedi , Neha Pandya , Parishi Thakore , Hemalatha Ramani , Riri G Trivedi , Soundappan Kathirvel
Complex Post-Traumatic Stress Disorder (CPTSD), based on ICD-11 guidelines, is differentiated from PTSD by several unique characteristics. Prolonged or frequent exposure to an event or series of events of extremely threatening or horrific nature increases the risk for CPTSD in adults. For PTSD, Reconsolidation of Traumatic Memories (RTM) has emerged as an effective intervention. There are limited studies on how to address CPTSD. Hence, RTM's effectiveness for CPTSD has not yet been established. In India, there are very few studies on PTSD (focusing mainly on natural disasters and violence), none on CPTSD and none on the effectiveness of RTM. Unfortunately, India, with >400 million young individuals and with high prevalence and limited identification of mental health issues, has a major gap in this area. This quasi-experimental pilot study aimed to assess the effectiveness of the RTM intervention for individuals with CPTSD at a wellness centre in India.
The participants (>18 years, n = 107) who reached out to a wellness center for help were assessed by two trained therapists (including a psychologist) based on the presenting problems for CPTSD using the International Trauma Questionnaire. Additional assessments included Major Depression Inventory and Generalized Anxiety Disorder-7. Based on the index-trauma framework, RTM intervention was delivered. Post-measurements were done (a) after one month or at least after five sessions and (b) after three months.
After one month (or five sessions), the CPTSD status changed to “none” (no diagnosis) for 80 and “PTSD” for 2 individuals. The results were sustained post-three months (n = 30). The paired t-test confirmed the overall reduction in CPTSD score after one month compared to baseline and even after three months compared to after one month, based on statistical significance (p < .01). The findings confirmed the effectiveness of RTM intervention for individuals with CPTSD. The study's limitations (quasi-experimental design, urban, English-speaking Indians) could be addressed in future work.
根据 ICD-11 指南,复杂创伤后应激障碍(CPTSD)与创伤后应激障碍有几个独特的特征。长期或频繁接触极具威胁性或恐怖性的事件或系列事件会增加成人罹患 CPTSD 的风险。对于创伤后应激障碍,创伤记忆再巩固(RTM)已成为一种有效的干预措施。关于如何治疗 CPTSD 的研究还很有限。因此,RTM 对 CPTSD 的有效性尚未确定。在印度,关于创伤后应激障碍的研究很少(主要集中在自然灾害和暴力方面),关于 CPTSD 的研究也很少,关于 RTM 的有效性的研究也很少。不幸的是,印度有 4 亿年轻人,精神健康问题的发病率高且识别能力有限,因此在这一领域存在很大差距。这项准实验性试点研究旨在评估 RTM 对印度一家健康中心 CPTSD 患者的干预效果。向健康中心求助的参与者(>18 岁,n = 107)由两名训练有素的治疗师(包括一名心理学家)使用国际创伤问卷对 CPTSD 现象问题进行评估。其他评估包括重度抑郁量表和广泛性焦虑症-7。根据创伤指数框架,进行 RTM 干预。一个月(或五个疗程)后,80 人的 CPTSD 状态变为 "无"(无诊断),2 人的 CPTSD 状态变为 "创伤后应激障碍"。这一结果在三个月后(n = 30)得以持续。配对 t 检验证实,与基线相比,一个月后 CPTSD 得分总体下降,与一个月后相比,三个月后 CPTSD 得分甚至下降,这在统计学上具有显著性(p <.01)。研究结果证实了 RTM 干预对 CPTSD 患者的有效性。研究的局限性(准实验设计、城市、讲英语的印度人)可在今后的工作中加以解决。
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引用次数: 0
Mental health and perceived consequences in a clinical sample of women featured in video-based pornography 视频色情制品中女性临床样本的心理健康和感知后果
IF 2 Q3 PSYCHIATRY Pub Date : 2024-10-31 DOI: 10.1016/j.ejtd.2024.100482
Fabienne El-Khoury Lesueur , Véronique Héroin , Marion Fareng

Context

Several reports have shed light on the potentially traumatic filming conditions, and violence experienced by women featured in pornography (WP). However, there is a scarcity of research on the mental health of these women, as well as the perceived consequences of participation in Video-based Pornography (VbP).

Methods

Thirty-six women, recruited through collaboration with WP support groups, completed an online questionnaire covering socio-demographics, pre-VbP violence experiences, and perceived consequences of their participation in VbP. Additionally, participants completed the French versions of the post-traumatic stress disorder (PTSD) Checklist for DSM-5 (PCL-5), the Dissociative Experiences Scale (DES-II), and the 13-item Beck Depression Inventory (BDI-13).

Results

The participants had a mean age of 31.2 years (SD = 7), and the median age at first participation in VbP was 21. A majority (77.8 %) reported a lifetime experience of sexual violence before featuring in VbP. All participants reported at least one negative effect of participating in VbP, with three in four women citing cyberbullying following VbP dissemination. Additionally, participants reported a range of physical consequences such as vaginal lesions and sexually transmitted diseases. Thirty women (83 %) had a PCL-5 score over 33, indicative of probable PTSD, and 28 women (78 %) had a DES-II score of 30 or more, indicating high levels of dissociative symptoms. Furthermore, 19 women (53 %) reported a BDI-13 score over 13, suggesting potential severe depression.

Conclusion

This study underscores psychosocial vulnerabilities and the presence of severe psychopathology among WP. It also documents their perceptions of negative consequences of participation in VbP, such as cyberbullying, physical injuries, and emotional distress. Further, large-scale studies are needed to substantiate these results and better understand the scale of the problem, as well as to optimize care interventions.
背景有几份报告揭示了色情制品(WP)中的女性在拍摄过程中可能遭受的创伤和暴力。方法通过与 WP 支持团体合作招募了 36 名女性,她们填写了一份在线调查问卷,内容包括社会人口统计、参与 VbP 前的暴力经历以及参与 VbP 的后果。此外,参与者还填写了法文版的创伤后应激障碍(PTSD)核对表(PCL-5)、分离体验量表(DES-II)和 13 项贝克抑郁量表(BDI-13)。结果参与者的平均年龄为 31.2 岁(SD = 7),首次参与 VbP 的年龄中位数为 21 岁。大多数参与者(77.8%)表示,在参加 VbP 之前,一生中都曾遭受过性暴力。所有参与者都报告了参与 VbP 带来的至少一种负面影响,每四名女性中就有三人在 VbP 传播后受到网络欺凌。此外,参与者还报告了一系列身体后果,如阴道损伤和性传播疾病。30 名妇女(83%)的 PCL-5 得分超过 33 分,表明可能患有创伤后应激障碍,28 名妇女(78%)的 DES-II 得分超过 30 分,表明存在严重的分离症状。此外,19 名妇女(53%)的 BDI-13 得分超过 13 分,表明她们可能患有严重的抑郁症。这项研究还记录了他们对参与网络暴力的负面影响的看法,如网络欺凌、身体伤害和情绪困扰。为了证实这些结果、更好地了解问题的严重程度以及优化护理干预措施,还需要进行更大规模的研究。
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引用次数: 0
Résistance et trauma: introduire l'existence 抵抗与创伤:介绍存在
IF 2 Q3 PSYCHIATRY Pub Date : 2024-10-28 DOI: 10.1016/j.ejtd.2024.100477
Jean-Michel DARVES-BORNOZ MD, PhD
Resilience is implicitly thought as a capacity that some have, but that no one has done much to obtain, so that the notion of resistance to narcissistic and traumatic wounds, remains necessary. Resistance evokes an unconscious obstruction in metapsychology, or martial in history. The meaning in our case is different: resisting trauma is an emotional and intellectual effort to move beyond a stupefying awareness. This includes that: perception is not neutral; existence fragments the psyche; both intergenerational and adversity determine distinct self-states. The article presents five theses upon which existential analysis can rely. The latter re-founds existences where usual therapies renounces to do so: persistent traumatic states. Symptoms may disappear in course of analysis, including excessive dissociative archaic defences, physical or mental, although it aims elsewhere. Existential analysis seeks to reveal to subjects that they are abdicating their freedom if they consider received ideas about the world as free choices.
复原力被隐含地认为是一种能力,有些人拥有这种能力,但没有人做过什么来获得这种能力,因此,抵抗自恋和创伤的概念仍然是必要的。在元心理学中,"抵抗 "是一种无意识的阻碍,在历史学中,"抵抗 "是一种武术。在我们的案例中,其含义有所不同:抵抗创伤是一种情感和智力上的努力,以超越令人窒息的意识。这包括:感知不是中性的;存在使心理支离破碎;代际和逆境决定了不同的自我状态。文章提出了存在论分析可以依赖的五个论点。后者在常规疗法放弃的地方重新发现存在:持续的创伤状态。在分析过程中,症状可能会消失,包括过度的分离性古老防御,身体或精神上的,尽管它的目标在别处。存在主义分析试图向研究对象揭示,如果他们将关于世界的既定观念视为自由选择,那么他们就是在放弃自己的自由。
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引用次数: 0
Adverse childhood experiences and dissociation among Italian public psychology service users 意大利公共心理服务使用者的不良童年经历和分离现象
IF 2 Q3 PSYCHIATRY Pub Date : 2024-10-28 DOI: 10.1016/j.ejtd.2024.100476
Giuseppe Scimeca, Marianna Ardito, Rosario D'Avenia
Different studies have provided evidence that adverse childhood experiences (ACEs) are associated with mental health problems as a function of racial and ethnic diversity. The aim of the present study was thus to study the association between ACEs and dissociation in a sample of Southern Italian public psychology service (PPS) users. A sample of 183 adults who requested psychotherapeutic treatment within an Italian PPS was recruited. ACEs were assessed via the Adverse Childhood Experiences Questionnaire (ACE-Q). Dissociative symptoms were assessed via the Dissociative Experiences Scale (DES-II) and the Somatoform Dissociation Questionnaire (SDQ-20). Dissociative syndromes were assessed via two scales of the Millon Clinical Multiaxial Inventory (MCMI-III): the Somatoform Syndrome (H) and the Post-Traumatic Stress Disorder Syndrome (R) scales. The most common types of ACEs in our sample were emotional neglect and emotional abuse. The number of ACEs showed a significant association with all the different measures of dissociation administered. Logistic regression analysis for the DES-II resulted in a solution made up of sexual abuse and parental separation or divorce. The regression analysis for the SDQ-20 resulted in a solution made up of emotional abuse, physical neglect, and parental separation or divorce. Sexual abuse positively predicted PTSD scale scores, while no solution was found for somatoform disorder. ACEs and dissociation were strongly associated in this study, but the nature of this association depended on the aspect of dissociation under investigation, particularly when we considered the distinction between dissociative symptoms versus syndromes. Cultural characteristics and clinical implications for public services are discussed.
不同的研究证明,童年的不良经历(ACEs)与心理健康问题有关,这与种族和民族多样性有关。因此,本研究旨在研究意大利南部公共心理服务(PPS)使用者样本中的ACE与分离之间的关联。研究人员在意大利一家公共心理服务机构招募了 183 名要求接受心理治疗的成年人。ACE通过童年不良经历问卷(ACE-Q)进行评估。分离症状通过分离体验量表(DES-II)和躯体形式分离问卷(SDQ-20)进行评估。分离综合征通过米隆临床多轴量表(MCMI-III)的两个量表进行评估:躯体形式综合征量表(H)和创伤后应激障碍综合征量表(R)。在我们的样本中,最常见的 ACE 类型是情感忽视和情感虐待。ACE 的数量与所有不同的解离度量表都有显著关联。DES-II 的逻辑回归分析得出的解决方案是性虐待和父母分居或离婚。对 SDQ-20 进行回归分析后得出的解决方案由情感虐待、身体忽视和父母分居或离婚组成。性虐待对创伤后应激障碍量表得分有积极的预测作用,而对躯体形式障碍则没有发现任何解决方案。在本研究中,ACE 与解离密切相关,但这种关联的性质取决于所调查的解离方面,特别是当我们考虑到解离症状与综合症之间的区别时。本研究讨论了文化特征和对公共服务的临床影响。
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引用次数: 0
Exploring the interplay between dreams, Early Maladaptive Schemas and demanding parenting style in Malaysia: A qualitative study 探索马来西亚儿童的梦想、早期适应不良模式和苛刻的养育方式之间的相互作用:定性研究
IF 2 Q3 PSYCHIATRY Pub Date : 2024-10-26 DOI: 10.1016/j.ejtd.2024.100478
Jin Chien Gan, Shubashini Mathialagan, Amos En Zhe Lian
The demanding parenting style is a dysfunctional parenting behaviour which involves strict rules, overprotectiveness, high standards, and little affection or emotional support. It is commonly found in the Asian community. Extensive studies have suggested that this parenting style would contribute to various severe impacts, which include the development of early maladaptive schemas (EMS). Interestingly, EMS has been found to represent itself in dreams through themes and symbols. With this, the current study employed qualitative interviews to analyse the relationship between EMS and dreams in eight Malaysian young adults who experienced demanding parenting styles. The current study found that a demanding parenting style is associated with six EMS, which are (1) abuse/mistrust, (2) failure, (3) pessimism/negativity, (4) unrelenting standard/hypercriticalness, (5) approval seeking/recognition seeking, and (6) social isolation/alienation. These EMS manifested themselves in dreams. Based on these findings, the use of EMS in dream analysis has the potential to be an effective mediator to understand and explore the individuals’ past history.
苛刻型教养方式是一种功能失调的教养行为,包括严格的规则、过度保护、高标准、很少关爱或情感支持。这种教养方式常见于亚裔社区。大量研究表明,这种养育方式会造成各种严重影响,其中包括早期适应不良图式(EMS)的形成。有趣的是,EMS 被发现会通过主题和符号在梦中表现出来。有鉴于此,本研究采用定性访谈的方式,分析了八名马来西亚年轻人的EMS与梦境之间的关系。本研究发现,苛刻的养育方式与六种EMS有关,分别是:(1) 虐待/不信任;(2) 失败;(3) 悲观/消极;(4) 无情的标准/过度挑剔;(5) 寻求认同/认可;(6) 社会孤立/疏远。这些 EMS 表现在梦境中。基于这些发现,在梦境分析中使用 EMS 有可能成为了解和探索个人过去历史的有效中介。
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引用次数: 0
Parent-Child EMDR therapy for children aged 0–4 years: Protocol, pilot-data, and case study 针对 0-4 岁儿童的亲子 EMDR 治疗:方案、试点数据和案例研究
IF 2 Q3 PSYCHIATRY Pub Date : 2024-10-19 DOI: 10.1016/j.ejtd.2024.100475
Marianne Went , Arianne Struik , Eline Möller , Bonne J.H. Zijlstra , Anja Dumoulin , Gerinda van Haaften , Roos Rodenburg
This article describes the Parent-Child EMDR protocol for children (0–4 years) and provides a summary of treatment data of an explorative pilot study with 18 children aged 0–4 years, illustrated with a case study. The Parent-Child EMDR protocol follows the EMDR standard protocol with adaptations only where imperative due to the age of the child and integrating research in the field of infant mental health, attachment, memory, and EMDR and its working mechanisms. As such, it provides an alternative to Storytelling (Lovett, 1999, 2015), which uses a preconstructed narrative predominantly focusing on resourcing and cognitive information. The brief customized treatment consists of a combination of the following components: preparation, EMDR with child and parents, EMDR for the parent, if necessary, parent-child interaction sessions, and parental guidance sessions. Focus lays on the child and parents’ internal associative processes after maximum activation of the child and parent's traumatic material, to allow the child's and parent's inherent capacity to integrate, through associations and by using the adaptive information experienced in their interaction during the session. Through this process, the parent-child interaction and attachment relationships improve, as well as the parent's mentalizing ability and confidence.
In an explorative pilot study, treatment data of 18 children between 0 and 4 years were gathered to obtain insight into the Parent-Child EMDR protocol and its effect on PTSD symptoms. Therapists scored PTSD symptom clusters of the DC 0–5 criteria. All children lost their PTSD diagnosis after treatment. A case example illustrates the use of this protocol in more detail. The Parent-Child EMDR protocol is a promising short and customized treatment to help child and parents overcome their trauma symptoms, resume normal development, and build healthy attachment relationships.
本文介绍了针对儿童(0-4 岁)的亲子 EMDR 方案,并提供了一项探索性试点研究的治疗数据摘要,该研究涉及 18 名 0-4 岁儿童,并通过一个案例进行了说明。亲子EMDR方案遵循EMDR标准方案,仅在必要时根据儿童的年龄进行调整,并整合了婴儿心理健康、依恋、记忆、EMDR及其工作机制等领域的研究。因此,它是讲故事(Lovett,1999 年,2015 年)的替代方案,后者使用预先构建的叙事,主要侧重于资源和认知信息。简短的定制治疗由以下部分组合而成:准备、儿童和父母的 EMDR、父母的 EMDR(如有必要)、亲子互动课程和父母指导课程。在最大限度地激活儿童和父母的创伤材料后,重点放在儿童和父母的内部联想过程上,让儿童和父母通过联想,利用他们在治疗过程中互动体验到的适应信息,发挥其固有的整合能力。在一项探索性试点研究中,收集了 18 名 0 至 4 岁儿童的治疗数据,以深入了解亲子 EMDR 方案及其对创伤后应激障碍症状的影响。治疗师根据 DC 0-5 标准对创伤后应激障碍症状群进行评分。所有儿童在治疗后都不再被诊断为创伤后应激障碍。一个案例更详细地说明了该方案的使用。亲子 EMDR 方案是一种很有前途的短期定制治疗方法,可帮助儿童和父母克服创伤症状,恢复正常发育,并建立健康的依恋关系。
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引用次数: 0
Représentations d'attachement, traits de personnalité limite en émergence et comportements extériorisés d'enfants maltraités et issus de la population générale 受虐待儿童和普通儿童的依恋表征、新出现的边缘型人格特征和外化行为
IF 2 Q3 PSYCHIATRY Pub Date : 2024-10-17 DOI: 10.1016/j.ejtd.2024.100472
Olivier Didier , Miguel M. Terradas , Rosalie Guillemette , Ana Carolina Rengel

Introduction

Abused children, especially those in residential care, show more externalized behaviors than children from the general population. These externalized behaviors may be a developmental consequence of different forms of abuse perpetrated by the parent, whose role is to support the child. Child maltreatment can also result in emerging borderline personality features (EBPT) related to socio-cognitive, emotional, relational, behavioral, and identity deficits.

Objective

The main objective of this research is to explore the links between the child's representations of maternal support and the presence of EBPF and externalized behaviors.

Method

Thirty-three foster care children and 40 children from the general population (7 to 12 years old) participated in the study. A semi-structured play activity measuring the child's representations of maternal support and a questionnaire assessing EBPF were administered to the children. The adult responsible for the child completed a questionnaire evaluating externalized behaviors.

Results

Mean comparisons confirm an increased presence of externalized behaviors and EBPF among the children in residential care. Representations of the mother as being unsupportive are associated with more EBPF. The increased presence of EBPF is linked to more externalized behaviors. Regression analysis attests to the mediating role of EBPF in the relationship between children's representations of maternal support and externalized behaviors.

Conclusion

These findings underscore the role of the mother-child relationship in personality development. An altered mother-child relationship appears to lead to deficits, particularly in the child's ability to manage situations that arouse aggression.
导言:与普通儿童相比,受虐待儿童(尤其是寄宿儿童)表现出更多的外化行为。这些外化行为可能是父母不同形式虐待的发展结果,而父母的角色是抚养儿童。本研究的主要目的是探讨儿童对母亲支持的表述与 EBPF 和外化行为之间的联系。方法33 名寄养儿童和 40 名普通儿童(7 至 12 岁)参加了本研究。研究人员对儿童进行了一项半结构化游戏活动,以测量儿童对母亲支持的表述,并对 EBPF 进行了问卷评估。负责照顾儿童的成人填写了一份评估外化行为的问卷。结果 平均比较证实,寄宿儿童的外化行为和 EBPF 有所增加。认为母亲不支持自己的表象与 EBPF 增加有关。EBPF的增加与更多的外化行为有关。回归分析证明,EBPF 在儿童的母亲支持表象与外化行为之间起着中介作用。母子关系的改变似乎会导致儿童的缺陷,尤其是在处理引起攻击行为的情境方面。
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引用次数: 0
Anxio-depressive disorders, traumatic symptoms, and suicidality among limb amputees: A cross-sectional and prospective study 肢体截肢者的焦虑抑郁障碍、创伤症状和自杀倾向:横断面和前瞻性研究
IF 2 Q3 PSYCHIATRY Pub Date : 2024-10-15 DOI: 10.1016/j.ejtd.2024.100471
Jihane Moussaoui , Achraf Tebbaa El Hassali , Manal Gharibi , Omar Agoumi , Adnane Benzirar , Abdeljaouad Najib , Mohammed Barrimi

Introduction

Limb amputation represents an ultimate therapeutic option in certain severe or progressive pathologies. We conducted this study to describe anxio- depressive disorders, traumatic symptoms, and suicidality among limb amputees, as well as factors associated with their occurrence.

Materials and Methods

This was a cross-sectional and prospective descriptive and analytical study conducted over a two-year period from October 2020 to October 2022, at the following departments of the Mohammed VI University Hospital Center in Oujda: Traumatological and Orthopedic Surgery departements A and B, and Peripheral Vascular Surgery departement, involving 122 patients.

Results

The average age of our patients was 46.42 ± 14.76 years, with a predominance of males (male-to-female ratio of 2.21). Preoperative assessment of patients occurred 6 to 24 h before amputation. Immediate postoperative evaluation took place on average 2.18 ± 1.53 days after surgery, ranging from 1 to 8 postoperative days. The prevalence of anxio-depressive disorders according to the MINI scale was 77 %, comprising Depression (9 %), Adjustment Disorder (36.9 %), Acute Stress Disorder (20.5 %), Post-Traumatic Stress Disorder (6.6 %), and Anxiety Disorders (10.7 %), with suicide attempts reported in 16.4 % of cases. The mean score on the Hamilton Depression Rating Scale for our patients was 10.81 ± 3.27, on the Hamilton Anxiety Rating Scale was 16.33 ± 5.54, and on the Ducher Suicide Risk Scale was 0.82 ± 1.33.

Conclusion

The occurrence of postoperative anxio-depressive disorders, traumatic symptoms, and suicidal behavior is associated with the following factors: male sex, personal history of depression, family history of psychiatric disorders, quality of diagnostic disclosure, postoperative sleep disturbances, postoperative panic attacks, psychological support, and socio-professional reintegration.
导言截肢是某些严重或进展性疾病的最终治疗选择。我们开展了这项研究,以描述肢体截肢者的焦虑抑郁症、创伤症状和自杀倾向,以及与之相关的因素。材料与方法这是一项横断面前瞻性描述性分析研究,研究时间为 2020 年 10 月至 2022 年 10 月,为期两年,在乌季达穆罕默德六世大学医院中心的以下部门进行:结果患者平均年龄(46.42 ± 14.76)岁,男性居多(男女比例为 2.21)。患者的术前评估在截肢前 6 至 24 小时进行。术后即时评估平均在术后 2.18 ± 1.53 天进行,时间从术后 1 天到 8 天不等。根据MINI量表,焦虑抑郁症的发病率为77%,包括抑郁症(9%)、适应障碍(36.9%)、急性应激障碍(20.5%)、创伤后应激障碍(6.6%)和焦虑障碍(10.7%),其中16.4%的病例有自杀企图。患者的汉密尔顿抑郁评分量表(Hamilton Depression Rating Scale)平均得分为 10.81 ± 3.27,汉密尔顿焦虑评分量表(Hamilton Anxiety Rating Scale)平均得分为 16.33 ± 5.54,杜彻自杀风险量表(Ducher Suicide Risk Scale)平均得分为 0.82 ± 1.33。结论 术后焦虑抑郁障碍、创伤症状和自杀行为的发生与以下因素有关:男性、个人抑郁史、家族精神病史、诊断披露质量、术后睡眠障碍、术后惊恐发作、心理支持和社会职业重新融入。
{"title":"Anxio-depressive disorders, traumatic symptoms, and suicidality among limb amputees: A cross-sectional and prospective study","authors":"Jihane Moussaoui ,&nbsp;Achraf Tebbaa El Hassali ,&nbsp;Manal Gharibi ,&nbsp;Omar Agoumi ,&nbsp;Adnane Benzirar ,&nbsp;Abdeljaouad Najib ,&nbsp;Mohammed Barrimi","doi":"10.1016/j.ejtd.2024.100471","DOIUrl":"10.1016/j.ejtd.2024.100471","url":null,"abstract":"<div><h3>Introduction</h3><div>Limb amputation represents an ultimate therapeutic option in certain severe or progressive pathologies. We conducted this study to describe anxio- depressive disorders, traumatic symptoms, and suicidality among limb amputees, as well as factors associated with their occurrence.</div></div><div><h3>Materials and Methods</h3><div>This was a cross-sectional and prospective descriptive and analytical study conducted over a two-year period from October 2020 to October 2022, at the following departments of the Mohammed VI University Hospital Center in Oujda: Traumatological and Orthopedic Surgery departements A and B, and Peripheral Vascular Surgery departement, involving 122 patients.</div></div><div><h3>Results</h3><div>The average age of our patients was 46.42 ± 14.76 years, with a predominance of males (male-to-female ratio of 2.21). Preoperative assessment of patients occurred 6 to 24 h before amputation. Immediate postoperative evaluation took place on average 2.18 ± 1.53 days after surgery, ranging from 1 to 8 postoperative days. The prevalence of anxio-depressive disorders according to the MINI scale was 77 %, comprising Depression (9 %), Adjustment Disorder (36.9 %), Acute Stress Disorder (20.5 %), Post-Traumatic Stress Disorder (6.6 %), and Anxiety Disorders (10.7 %), with suicide attempts reported in 16.4 % of cases. The mean score on the Hamilton Depression Rating Scale for our patients was 10.81 ± 3.27, on the Hamilton Anxiety Rating Scale was 16.33 ± 5.54, and on the Ducher Suicide Risk Scale was 0.82 ± 1.33.</div></div><div><h3>Conclusion</h3><div>The occurrence of postoperative anxio-depressive disorders, traumatic symptoms, and suicidal behavior is associated with the following factors: male sex, personal history of depression, family history of psychiatric disorders, quality of diagnostic disclosure, postoperative sleep disturbances, postoperative panic attacks, psychological support, and socio-professional reintegration.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"8 4","pages":"Article 100471"},"PeriodicalIF":2.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142532405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ethical approach in a posttraumatic stress disorder 创伤后应激障碍的伦理方法
IF 2 Q3 PSYCHIATRY Pub Date : 2024-10-13 DOI: 10.1016/j.ejtd.2024.100473
Sami Richa , Lyna Chami , Nathalie Richa , Wissam El-Hage

Background and objective

We will discuss autonomy, beneficence, non-maleficence and justice regarding trauma.

Method

A review of some papers regarding this subject and our experience nourished from our clinical practice.

Results

Respect of these ethical issues is important in order to improve to promote healing and resilience of subjects suffering from PTSD.

Conclusions

Ethical issues are important in all psychiatric and psychological issues.
背景和目的我们将讨论有关创伤的自主性、受益性、非恶意性和公正性。方法回顾了有关这一主题的一些论文以及我们在临床实践中积累的经验。结果尊重这些伦理问题对于改善创伤后应激障碍患者的治疗和恢复能力非常重要。结论伦理问题在所有精神和心理问题中都很重要。
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引用次数: 0
期刊
European Journal of Trauma & Dissociation
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