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Portigliatti Pomeri A, La Salvia A, Carletto S, Oliva F, Ostacoli L. EMDR in Cancer Patients: A Systematic Review. Front Psychol 2021; 11:590204. [PMID: 33536968 PMCID: PMC7847844 DOI: 10.3389/fpsyg.2020.590204] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 12/16/2020] [Indexed: 11/24/2022] Open
Abstract
Background: Psychological distress is common among patients with cancer, with severe consequences on their quality of life. Anxiety and depression are the most common clinical presentation of psychological distress in cancer patients, but in some cases cancer may represent a traumatic event resulting in posttraumatic stress disorder (PTSD). Currently, Eye Movement Desensitization and Reprocessing (EMDR) therapy is considered an evidence-based treatment for PTSD, but recent studies also showed its effectiveness for anxiety and depression. The aim of the present systematic review is to summarize the current literature on the effect of EMDR on cancer-related psychological distress. Methods: A literature search was conducted for peer-reviewed articles about "EMDR" and "cancer patients" in the following electronic databases: PubMed, MEDLINE, Science Direct, Google Scholar, and Cochrane library. Results: Our search identified 7 studies in which EMDR was used with a total of 140 cancer patients. The psychiatric diagnosis was PTSD in 3 studies. Otherwise, the diagnosis concerned the anxious and depressive disorder spectrum. Overall, EMDR treatment schedules used were highly heterogeneous, with a different number of sessions (from 2 to 12) and a different duration of therapy (up to 4 months). However, across all studies analyzed EMDR therapy was judged to be adequate in reducing symptoms of psychological distress in this population. Conclusions: According to the results of our analysis, the level of evidence regarding EMDR efficacy in cancer patients is limited by the scarcity of studies and their low methodological quality. Although better quality research is needed, available data suggest that EMDR could be a promising treatment for psychological distress in patients with cancer.
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Affiliation(s)
| | - Anna La Salvia
- Department of Oncology, 12 de Octubre University Hospital, Madrid, Spain
| | - Sara Carletto
- Department of Neuroscience “Rita Levi Montalcini”, University of Torino, Torino, Italy
- Clinical Psychology Unit, University Hospital City of Science and Health, Torino, Italy
| | - Francesco Oliva
- Department of Clinical and Biological Sciences, University of Torino, Orbassano, Italy
| | - Luca Ostacoli
- Clinical Psychology Unit, University Hospital City of Science and Health, Torino, Italy
- Department of Clinical and Biological Sciences, University of Torino, Orbassano, Italy
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Carletto S, Porcaro C, Settanta C, Vizzari V, Stanizzo MR, Oliva F, Torta R, Fernandez I, Coletti Moja M, Pagani M, Ostacoli L. Neurobiological features and response to eye movement desensitization and reprocessing treatment of posttraumatic stress disorder in patients with breast cancer. Eur J Psychotraumatol 2019; 10:1600832. [PMID: 31073391 PMCID: PMC6495116 DOI: 10.1080/20008198.2019.1600832] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 03/14/2019] [Accepted: 03/14/2019] [Indexed: 11/16/2022] Open
Abstract
Background: Breast cancer (BC) is one of the most common invasive types of cancer among women, with important consequences on both physical and psychological functioning. Patients with BC have a great risk of developing posttraumatic stress disorder (PTSD), but few studies have evaluated the efficacy of psychological interventions to treat it. Furthermore, no neuroimaging studies have evaluated the neurobiological effects of psychotherapeutic treatment for BC-related PTSD. Objective: The study aimed to evaluate the efficacy of Eye Movement Desensitization and Reprocessing therapy (EMDR) as compared to Treatment as Usual (TAU) in BC patients with PTSD, identifying by electroencephalography (EEG) the neurophysiological changes underlying treatments effect and their correlation with clinical symptoms. Method: Thirty patients with BC and PTSD diagnosis were included, receiving either EMDR (n = 15) or TAU (n = 15). Patients were assessed before and after treatments with clinical questionnaires and EEG. The proportion of patients who no longer meet criteria for PTSD after the intervention and changes in clinical scores, both between and within groups, were evaluated. Two-sample permutation t-tests among EEG channels were performed to investigate differences in power spectral density between groups. Pearson correlation analysis was carried out between power bands and clinical scores. Results: At post-treatment, all patients treated with EMDR no longer met criteria for PTSD, while all patients treated with TAU maintained the diagnosis. A significant decrease in depressive symptoms was found only in the EMDR group, while anxiety remained stable in all patients. EEG results corroborated these findings, showing significant differences in delta and theta bands in left angular and right fusiform gyri only in the EMDR group. Conclusions: It is essential to detect PTSD symptoms in patients with BC, in order to offer proper interventions. The efficacy of EMDR therapy in reducing cancer-related PTSD is supported by both clinical and neurobiological findings.
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Affiliation(s)
- Sara Carletto
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Camillo Porcaro
- Institute of Cognitive Sciences and Technologies, Consiglio Nazionale delle Ricerche, Rome, Italy.,S. Anna Institute and Research in Advanced Neurorehabilitation (RAN), Crotone, Italy.,Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy.,Centre for Human Brain Health and School of Psychology, University of Birmingham, Birmingham, UK
| | - Carmen Settanta
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | | | - Maria Rosa Stanizzo
- Clinical and Oncological Psychology, Città della Salute e della Scienza Hospital of Turin, Turin, Italy
| | - Francesco Oliva
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Riccardo Torta
- Department of Neurosciences, University of Turin, Turin, Italy.,Clinical and Oncological Psychology, Città della Salute e della Scienza Hospital of Turin, Turin, Italy
| | | | | | - Marco Pagani
- Institute of Cognitive Sciences and Technologies, Consiglio Nazionale delle Ricerche, Rome, Italy
| | - Luca Ostacoli
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.,Clinical and Oncological Psychology, Città della Salute e della Scienza Hospital of Turin, Turin, Italy
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