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Yıl:2012; Cilt: 13; Sayı: 1>> Özet
Anadolu Psikiyatri Dergisi; 2012;13(1):75-81
Fibromiyaljide EMDR'nin etkinliğinin araştırılması: Yedi olguyu içeren bir klinik çalışma
Ö Kavakcı, M Semiz, E Kaptanoğlu, Z Özer
Cumhuriyet Üniversitesi Tıp Fakültesi Psikiyatri Anabilim Dalı, Sivas
Amaç: Fibromiyalji sendromu (FMS) etiyolojisi belli olmayan, yaygın vücut ağrıları, belirli anatomik bölgelerde duyarlılık, azalmış ağrı eşiği, uyku bozuklukları, yorgunluk ve sıklıkla ruhsal sıkıntı ile karakterize eklem dışı roma-tizmal bir hastalıktır. Çeşitli yaklaşımlar denenmesine rağmen etkili bir tedavisi yoktur. FMS ile psikiyatrik bozuk-lukların ilişkisine sıklıkla vurgu yapılmakta ve FMS hastalarında ruhsal travma yaygınlığı dikkat çekmektedir. Kronik ağrılı durumlar için tedavi arayışları giderek daha fazla psikoterapi yaklaşımlarına yönelmiştir. Bu çalış-mada FMS tanısı konan yedi hastanın EMDR yaklaşımı ile tedavisine yanıtları araştırılmıştır. Yöntem: FMS tanısı konmuş 22-41 yaşları arasındaki altı kadın ve bir erkek olgunun tedavi öncesi ve sonrasında duyarlı nokta sayıları (DNS) belirlendi, Vizüel Ağrı Skalasında (VAS) bildirdikleri ağrı düzeyleri kaydedildi. Hastalar tedavi öncesi ve sonrasında Fibromiyalji Etki Anketi (FEA), Beck Depresyon Ölçeği (BDÖ), Travma Değerlendirme Ölçeği (TDÖ), Pittsburg Uyku Kalitesi Ölçeği (PUKÖ), Öfke Tarzı Ölçeğini (SÖÖTÖ) doldurdu. Hastalara varsa yaşadıkları trav-malara yönelik, saptanamadı ise ağrılarına yönelik beş-sekiz seans arasında EMDR tedavisi uygulandı. Bulgular: Tedavi sonunda hastaların bildirdikleri VAS, PUKÖ, FEA, TDÖ, BDÖ puanlarında anlamlı azalma olmuştur. Fizik muayene ile DNS'de anlamlı azalma bulunmuştur. SÖÖTÖ'de sürekli öfke, öfke içe ve öfke dışa puanlarında anlamlı değişme olmazken; öfke kontrol puanında görülen artma anlamlıdır. Tedavi sonunda altıncı olgu dışındaki hastaların FMS ölçütlerini karşılamadığı gözlenmiştir. Sonuç: Bu hasta grubunda FMS tedavisinde EMDR tedavi-sinin etkili olduğu düşünülmektedir.
EMDR treatment of fibromyalgia, a study of seven cases
Objective: 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. Though many approaches have been tried there is no effective treatment for FMS. The relationship between FMS and psychiatric disorders is known, recently some researches point to the frequency of psychological trauma in patients with FMS. The search for treatment for chronic painful conditions has more and more focused to psychotherapeutic approaches. In this study, seven patients diagnosed were attempted to be treated with EMDR approach. Methods: 22-41 [year]s aged six women and one man diagnosed with FMS were admitted to the study. Before and after the treatment tender point count was identified and patients scored their pain levels at Visuel Analog Scale. Patients filled in Beck Depression Inventory (BDI), The Posttraumatic Diagnostic Scale (PDS), Pittsburg Sleep Quality Index (PSQI), State-Trait Anger Scale (STAS). If the patients have reported, trauma was focused on, if they have not reported any trauma, pain was focused. Five-eight sessions of EMDR was applied to the patients. Results: After the treatment, there were statistically significant reduction in patient reported VAS, PSQI, FIQ, PDS, and BDI scores.There was signify-cant decrease in tender point counts. Though there was no change in trait anger, anger-in and anger-out subscores of STAS, the increase in anger management subscore was significant. After the treatment, none of the patients met the FMS criteria but one patient (6th patient). Conclusion: EMDR therapy was effective in the treatment of these patients with FMS.

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