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Yıl:2010; Cilt: 13; Sayı: 3>> Özet
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Klinik Psikiyatri Dergisi; 2010;13(3):143-151
EMDR Fibromiyalji Tedavisinde Yeni Bir Seçenek Olabilir mi? Olgu Sunumu ve Gözden Geçirme
Ö Kavakcı, E Kaptanoğlu, N Kuğu, O Doğan
Cumhuriyet Üniv. Tıp Fak. Psikiyatri ABD, Sivas
Fibromiyalji Sendromu (FMS) etyolojisi belli olmayan yaygın vücut ağrıları, belirli anatomik bölgelerde hassasiyet, azalmış ağrı eşiği, uyku bozuklukları, yorgunluk ve sıklıkla psikolojik sıkıntı ile karakterize eklem dışı romatizmal bir hastalıktır. FMS'de psikiyatrik komorbidite yüksektir ve son zamanlarda FMS ve psikolojik travma ilişkisini gösteren yayınlar artmaktadır. Bu olgu sunumunun amacı psikolojik travmaya yönelik bir tedavinin FMS'nin belirtilerini yatıştırıp yatıştırmayacağını değerlendirmektir. Bu amaç doğrultusunda Fizik Tedavi ve Rehabilitasyon (FTR) kliniğinden ilaç tedavisine iyi yanıt vermemiş FMS tanısı konulan bir hastada önce travma yaşantısı olup olmadığı değerlendirilmiş, ardından saptanan travmalarına yönelik göz hareketleriyle duyarsızlaştırma ve yeniden işleme (EMDR: Eye Movement Desensitization and Reprocessing) uygulanmıştır. Hasta; Beş yıldır şikâyetleri olan 34 yaşında, evli, kadın, ilaç kullanmıyor. Visuel Ağrı Skalasında (VAS) ağrı düzeyi 9-10, hassas nokta sayısı 15/18 olarak belirlendi. Beck Depresyon Ölçeği puanı (BDÖ) 22 ve Foa Travma Değerlendirme Ölçeği (TDÖ) puanı 41 olarak saptandı. EMDR tedavisi sonrasında; VAS 3, hassas nokta sayısı 11/18, TDÖ 6, BDÖ puanı 2 olarak bulundu. Hastanın 3 ve 6 aylık takipte iyilik halinin sürdüğü tespit edildi.Bu olgunun travmalarına yönelik tedavi uygulanması sonrasında hem psikiyatrik hem de somatik yakınmalarında belirgin düzelme görülmüş ve bu iyileşmenin olası mekanizmaları tartışılmıştır. FMS'li olgularda travmatik deneyimlerin aranması ve EMDR veya başka travma yönelimli yaklaşımların uygulanması olumlu sonuçlar verebilir.
EMDR: A New Choice of Treatment in Fibromyalgia? A Review and Report of a Case Presentation
Fibromyalgia syndrome (FMS) is a nonarticular rheumatic
disease with unknown etiology and is characterized by
widespread pain, increased tenderness in some anatomical
regions, increased pain sensitivity, sleep disorders,
fatigue and frequently by psychological distress.
Psychiatric comorbidity is high in FMS and reports denoting
to relationship of FMS and psychologial trauma have
increased recently. We aimed to assess whether or not a
treatment modality concerning trauma can alleviate
symptoms of FMS. One of the FMS patients who was
admitted to the outpatient department of Physical
Medicine and Rehabilitation was randomly assigned to
the present study. After that, assessed whether patients's
traumatic experiences, and the Eye Movement
Desensitization and Reprocessing (EMDR) therapy was
performed to the patient. A thirty-four [year] old female
married patient, had symptoms of FMS for five [year]s.
She was not on any medication. Intensity of her pain was
identfied as 10 by visuel analog scale (VAS), tender point
count was 15 out of 18 and the scores of Beck
Depression Scale (BDS) and The Post Traumatic
Diagnostic Scale (PDS) were 22 and 41, respectively.
After the EMDR treatment VAS score was 3, tender point
count was 11 and the scores of BDS and PDS were 2 and
6, respectively. The recovery was sustained at the 3rd
and 6th [month]s of follow up. In this case, we observed
amelioration in both psychiatric and somatic symptoms
of the patient after EMDR therapy and we discussed the
possible mechanisms of this recovery. Searching for
traumatic experiences and treating those traumas in FMS
patients by EMDR or similar methods may result in
favourable results.

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