Treating Post-traumatic Stress Disorder in Patients with Multiple Sclerosis: A Randomized Controlled Trial Comparing the Efficacy of Eye Movement Desensitization and Reprocessing and Relaxation Therapy

Abstract

Objective: Multiple Sclerosis (MS) is a demyelinating autoimmune disease that imposes a significant emotional burden with heavy psychosocial consequences. Several studies have investigated the association between MS and mental disorders such as depression and anxiety, and recently researchers have focused also on Post-traumatic Stress Disorder (PTSD). This is the first study that investigates the usefulness of proposing a treatment for PTSD to patients with MS.Methods: A randomized controlled trial with patients with MS diagnosed with PTSD comparing Eye Movement Desensitization and Reprocessing (EMDR; n = 20) and Relaxation Therapy (RT; n = 22). The primary outcome measure was the proportion of participants that no longer meet PTSD diagnosis as measured with Clinician Administered PTSD Scale 6-months after the treatment.Results: The majority of patients were able to overcome their PTSD diagnosis after only 10 therapy sessions. EMDR treatment appears to be more effective than RT in reducing the proportion of patients with MS suffering from PTSD. Both treatments are effective in reducing PTSD severity, anxiety and depression symptoms, and to improve Quality of Life.Conclusion: Although our results can only be considered preliminary, this study suggests that it is essential that PTSD symptoms are detected and that brief and cost-effective interventions to reduce PTSD and associated psychological symptoms are offered to patients, in order to help them to reduce the psychological burden associated with their neurological condition.Trial registration: NCT01743664, https://clinicaltrials.gov/ct2/show/NCT01743664

A systematic review of randomized trials of mind‐body interventions for PTSD

“…A recent study by Carletto and colleagues () compared relaxation therapy to EMDR among patients with multiple sclerosis who were diagnosed with PTSD. Within‐group analyses revealed large effect sizes for both conditions on clinician‐assessed and self‐reported PTSD symptoms and between‐groups analyses revealed no differences by treatment condition.…”

“…(), included more male participants (64% and 55%, respectively). Four of the studies used ITT analyses (Carletto et al., ; Hinton et al., ; Markowitz et al., ; Vaughan et al., ), while the remaining used completer analyses (Marks et al., ; Taylor et al., ; Zucker et al., ).…”

“…Five of the studies had a participant pool that was predominantly or all female (64% to 100%), while both Marks et al (1998) and Zucker et al (2009), included more male participants (64% and 55%, respectively). Four of the studies used ITT analyses (Carletto et al, 2016;Hinton et al, 2011;Markowitz et al, 2015;Vaughan et al, 1994), while the remaining used completer analyses (Marks et al, 1998;Taylor et al, 2003;Zucker et al, 2009).…”

“…In four studies (Hinton et al, 2011;Markowitz et al, 2015;Marks et al, 1998;and Taylor et al, 2003) large preto post within-group effect sizes for relaxation were reported indicating that the relaxation treatment had a salutary effect on PTSD symptoms. The remaining three studies (Carletto et al, 2016;Vaughan et al, 1994;Zucker et al, 2009) did not report within-group effect sizes but both reported reduced PTSD severity for all treatment conditions, including relaxation. Three of the studies (Carletto et al, 2016;Hinton et al, 2011;Marks et al, 1998) reported greater treatment efficacy for the target treatments than relaxation on the primary PTSD outcome measures.…”

Effect of a transactional model education program on coping effectiveness in women with multiple sclerosis

“…In a study of MS patients with posttraumatic stress disorder, the efficacy of two treatments including Eye Movement Desensitization and relaxation therapy was compared in two groups of patients. Results indicated that both methods were effective in reducing stress, anxiety, depression, and improving quality of life (Carletto et al., 2016). In another randomized controlled trial, Artemiadis and colleagues examined a stress management program that included progressive muscle relaxation and breathing techniques for relapsing–remitting MS patients.…”