A Non-randomized Controlled Trial of EMDR on Affective Symptoms in Patients With Glioblastoma Multiforme.

Monika Szpringer,Benedikt L Amann,Marzena Oledzka

doi:10.3389/fpsyg.2018.00785

Abstract

Glioblastoma multiforme (GBM) is a highly aggressive brain cancer and its survival after diagnosis is less than 2 years. Therefore, GBM patients are especially prone to co-occurring psychological conditions such as anxiety and depressive disorders. Furthermore, aggressive medical therapies affect patients’ lives, undermining their sense of meaning and coherence. The main aim of this study was to determine the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) therapy on anxiety, depression and sense of coherence in patients with GBM. Thirty-seven GBM-diagnosed women were included in this trial and received standard medical care. Of those, 18 patients were treated during 4 months with 10–12 individual EMDR sessions (60–90 minutes each). Nineteen GBM patients were used as a non-randomized control group as they consented to psychological evaluations but not to a psychotherapeutic intervention. The groups were homogeneous in terms of gender, age, educational level and treatment, but not in anxiety and depressive levels at baseline. All patients were evaluated at baseline, after treatment (4 months) and at follow-up (further 4 months) by the Hospital Anxiety and Depression Scale (HADS-M) and the Sense of Coherence Scale (SOC-29). Caregivers in both groups were interviewed by the Patient Caregiver Questionnaire after 4 months follow-up. Statistical analyses were conducted using ANOVA statistics, correlation and regression analysis. Results showed a statistically significant decrease in the EMDR group in anxiety, depression and anger, when compared to the experimental group. EMDR therapy also had a positive impact upon the sense of coherence level in the experimental group, whereas in the control group this declined. Finally, the caregivers reported beneficial outcomes of the EMDR therapy with less anxiety- and anger-related behaviors in patients in the experimental group compared to the control group. This study is the first to show beneficial effects of EMDR therapy in alleviating affective symptoms and improving coherence in a severe medically ill population with GBM.

Highlights

Cancers of the brain are among the greatest challenges of today’s medicine
We found first positive evidence of Eye Movement Desensitization and Reprocessing (EMDR) on affective symptoms and sense of coherence, an improvement in comprehensibility, manageability and meaningfulness, in a sample of female Glioblastoma multiforme (GBM) patients
The HADS-M questionnaire was used to determine the levels of anxiety, depression, and anger and showed approximately a 50% score decrease in all patients of the experimental group after EMDR therapy

Summary

Introduction

Cancers of the brain are among the greatest challenges of today’s medicine. Brain tumors, which are the most difficult to treat, are included in the Grade 4 group of cancers and are determined as high grade glioma (HGG) (Woehrer et al, 2013). Glioblastoma multiforme (GBM) belongs to this group and is the most malignant. It is responsible for around 3–4% of the mortalities among cancer patients (Carlsson et al, 2014; Razavi et al, 2016), with an average survival after diagnosis of approximately 15–17 months (Li et al, 2010; Huang et al, 2017). 5% of patients survive 5 years from diagnosis (Carlsson et al, 2014). Treatment strategies such as surgical intervention, chemotherapy, radiotherapy or steroid therapy with their wellknown side-effects represent a further burden for the patients beyond the diagnosis

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Conclusion