The feasibility of eye movement desensitization and reprocessing (EMDR) for older adults with posttraumatic stress disorder (PTSD) and comorbid psychiatric and somatic disorders.

Abstract

The aim of this study is to investigate the feasibility of eye movement desensitization and reprocessing (EMDR) therapy in older adults with posttraumatic stress disorder (PTSD), and to explicitly include information about presence of the comorbid psychiatric and somatic disorders as well as a history of traumatic events at treatment start. A nonrandomized feasibility study in a multicenter design was conducted with 25 older PTSD patients (60-84 years). Treatment consisted of weekly 1-hour EMDR sessions for PTSD during 3, 6, or maximum 9 months. PTSD diagnosis was assessed with Clinician Administered PTSD Scale for DSM-5 (CAPS-5) and PTSD Symptom Scale-Self Report (PSS-SR). We also operationalized PTSD symptom change on CAPS-5 and PSS-SR in loss of diagnosis according to DSM-5 and remission. Remission was defined as loss of diagnosis and no longer having any PTSD symptoms according to minimum severity scores on CAPS-5 (< 12) and PSS-SR (≤ 10). Comorbid psychiatric disorders were assessed pre- (and post-)treatment and somatic disorders and presence of traumatic (childhood) events were assessed pretreatment. Comorbidity rates of depressive (64%), anxiety (56%), other psychiatric (32%), personality (60%), and somatic disorders (96%) were high in our sample of older adults. A linear mixed model approach showed a significant decrease in CAPS-5 scores from pre- to posttreatment for the total sample [F(1, 24) = 150.304, p < .001; Cohen's d = 2.59]. No significant main effects of therapy duration (3, 6, or 9 months), pretreatment intensity of psychopathology (BSI), or their interaction was found (all p > .05). Eighty percent lost their PTSD diagnosis and remission rate was 52% for CAPS-5 and 37.5% for PSS-SR. Remission (not loss of PTSD-diagnosis) showed a negative correlation with the number of experienced traumatic childhood events. EMDR therapy showed large treatment effect on PTSD symptom severity in older adults and this was unrelated to therapy duration and presence of comorbid psychiatric and somatic disorders pretreatment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).