EMDR疗法对老年人有效吗？

EMDR疗法是治疗老年人创伤后应激障碍（PTSD）及相关问题的有效选择。

老年人中，创伤后应激障碍（PTSD）及共病的精神障碍和躯体疾病较为常见，且可能难以治疗。近年来，关于EMDR（眼动脱敏与再加工）疗法在老年人中的可行性和疗效的研究逐渐增多。

疗效与临床结果

• EMDR疗法可显著减轻老年人的PTSD症状，使80%的患者不再符合PTSD诊断标准。缓解率为37%–52%（Gielkens et al., 2022）。
• EMDR可降低老年人的衰弱程度，并提高生活质量（Gielkens et al., 2022）。
• 接受EMDR治疗后，也观察到了认知功能（尤其是记忆力和注意力）的改善（Gielkens et al., 2023）。
• 有研究报告，对于存在轻至中度认知障碍的老年人，EMDR也可减轻焦虑、睡眠问题及躯体不适（Mikhailova, 2015; Ahmed, 2018）。

人格障碍与共病

• 对于PTSD共病人格障碍的老年人，EMDR可改善人格功能，并减少符合人格障碍诊断标准的情况（Gielkens et al., 2023; Gielkens et al., 2024）。
• 尽管共病负担较高，EMDR的疗效仍不受治疗时长或基线精神病理症状严重程度的影响（Gielkens et al., 2022）。

安全性与可行性

• 老年人对EMDR的耐受性良好，尚未报告严重不良反应（Gielkens et al., 2022; Mikhailova, 2015）。
• 可对标准治疗方案进行调整，以适应存在认知或身体功能受限的老年人（Ahmed, 2018; Gielkens et.al., 2018）。

  结论

EMDR疗法是一种安全有效的治疗选择，可改善老年人的PTSD、共病精神障碍、衰弱状况及生活质量。通过个体化调整，该疗法也可用于存在认知或身体功能受限的老年人。不过，仍需要开展规模更大的对照研究。

参考文献

Gielkens, E., Sobczak, S., Rossi, G., & Van Alphen, S. (2022). The feasibility of eye movement desensitization and reprocessing (EMDR) for older adults with posttraumatic stress disorder (PTSD) and comorbid psychiatric and somatic disorders.. Psychological trauma : theory , research, practice and policy. https://doi.org/10.1037/tra0001402

Gielkens, E., Sobczak, S., Gerrits, N., Rosowsky, E., Stas, L., Rossi, G., & Van Alphen, S. (2023). EMDR in older adults with PTSD and comorbid personality disorders. International Psychogeriatrics. https://doi.org/10.1017/s104161022400019x

Gielkens, E., Turksma, K., Kranenburg, L., Stas, L., Sobczak, S., Van Alphen, S., & Rossi, G. (2022). Feasibility of EMDR in Older Adults with PTSD to Reduce Frailty and Improve Quality of Life. Clinical Gerontologist, 48, 37 - 47. https://doi.org/10.1080/07317115.2022.2114397

Gielkens, E., Sobczak, S., Gerrits, N., Rosowsky, E., Stas, L., Rossi, G., & Van Alphen, S. (2024). Feasibility of EMDR toward Personality Functioning in Older Adults with PTSD. Clinical Gerontologist, 48, 48 - 59. https://doi.org/10.1080/07317115.2024.2344793

Mikhailova, E. (2015). Application of EMDR in the Treatment of Older People with a History of Psychical Trauma. European Psychiatry, 30, 1 - 1. https://doi.org/10.1016/s0924-9338(15)30664-7

Ahmed, A. (2018). EMDR Therapy for an Elderly Woman With Depression, Traumatic Memories, and Parkinson’s Disease Dementia: A Case Study. Journal of EMDR Practice and Research , 12, 16 - 23. https://doi.org/10.1891/1933-3196.12.1.16

Gielkens, E., Rossi, G., Van Alphen, S., & Sobczak, S. (2023). A First Exploration: Can Eye Movement Desensitization and Reprocessing Improve Cognition in Older Adults With Posttraumatic Stress Disorder?. Journal of Geriatric Psychiatry and Neurolog y, 37, 206 - 221. https://doi.org/10.1177/08919887231207639

Gielkens, E., Vink, M., Sobczak, S., Rosowsky, E., & Van Alphen, B. (2018). EMDR in Older Adults With Posttraumatic Stress Disorder. The Journal of EMDR Practice and Research , 12, 132 - 141. https://doi.org/10.1891/1933-3196.12.3.132