Eye movement desensitization and reprocessing (EMDR) in patients of PTSD following earthquake 2005, Pakistan

Objective: The purpose of the study is to asses the usefulness of EMDR in patients of PTSD who survived the October 2005 earthquake in Pakistan. Background: On October the 8th an earthquake of 7.6 on rector scale struck Kashmir and Northwest of Pakistan leaving millions injured and more than 80,000 dead. A survey of the affected areas has shown a high prevalence of PTSD amongst the survivors. A selected series of patients with the diagnosis of PTSD from amongst the survivors is enrolled for EMDR at CTRPI. The study is based on their response to this intervention. Design and Settings: The study involves an ongoing compilation of clinical data and the study of therapeutic responses to various interventions including EMDR, at a tertiary mental health facility and Centre for Trauma Research and Psychosocial Interventions (CTRPI), Rawalpindi /Islamabad, Pakistan. This mental health facility is the tertiary care referral point for patients from metal health relief units located allover in earthquake affected areas of Azad Kashmir and Northwest of Pakistan. Method: Earthquake survivors who develop psychosocial sequelae referred to CTRPI from Kashmir, who go on to fulfill the criteria of Post-traumatic Stress Disorder according to ICD-10 are registered for further studies and appropriate interventions. A select group who give informed consent for EMDR are then included for detailed evaluation and follow up. Sessions are conducted in eight phases from manuals by therapists who are trained till level 2 in the method. Pre- treatment assessment is done by an independent assessor for scores on Impact of Event Scale and Global Assessment of Functioning (GAF). The post treatment assessment is conducted 1 week after the treatment with the same procedures as at pretreatment. In session Scoring of subjective unit of distress is also recorded serially. According to the degree of improvement and severity of illness, sessions of EMDR are carried out with the duration of about 60 to 90 minutes each session and with a minimum of 6 sessions using the bilateral stimulation. The authors plan to compile their work with ten patients who fulfill the prerequisites of the study in process. Results: The work has been done so far on three clients which suggest that EMDR is effective in reducing the scores of IES back to normal and there is marked difference in the GAF level after the said intervention. It has a dramatic effect on 29 within-session SUD levels .Furthermore, at a qualitative level it is observed that involvement of other family members in the therapeutic process may improve treatment adherence. Conclusions: Ongoing results of this study tend to suggest that the EMDR is an effective intervention for patients of PTSD following a natural disaster like an earth quake. However, the results drawn cannot be generalized on account of their small count.

Conference

English

Ali, M. W., & Rana, M. H. (2008, June). Eye movement desensitization and reprocessing (EMDR) in patients of PTSD following earthquake 2005, Pakistan. Presentation at the 9th EMDR Europe Association Conference, London, England