Stressful, sometimes traumatic, a visit to the emergency room is not without consequences for patients. According to researchers attached to Inserm, however, it would be possible to alleviate post-concussion syndromes and post-traumatic stress disorders through an early session of EMDR, a therapy that acts on the patient’s psyche.
Whatever the reason that brings a patient to the emergency department of a hospital or a clinic, his passage will not be without consequences for his mental well-being. According to a study published in 2012, more than 10 million people frequent emergencies in France each year. 18 million annual visits are counted if multiple passages are taken into account.
Post-concussion syndrome and post-traumatic stress disorder
Among all these patients going to the emergency room, some will have sequelae. It must be said that going to the emergency services can be stressful, even traumatic. Crowded room, harsh light, sometimes very long waiting time, expeditious treatment due to a lack of personnel … All these causes lead 10 to 20% of patients to suffer for several months from persistent symptoms (headaches, difficulties in concentration, sensory disturbances, irritability) grouped together under the term post-concussion syndrome. 5% of patients will suffer from post-traumatic stress disorder (PTSD), which results in symptoms classically described in people who have experienced a situation during which their physical or psychological integrity or that of those around them has been threatened or reached.
How can we make these emergency visits less stressful and traumatic for patients? Inserm researchers from the “Bordeaux Population Health” research center of the Bordeaux University Hospital and the Cadillac hospital center may have found the answer.
In a study, they sought to lower the stress levels of patients attending emergency departments, with the ultimate goal of preventing the onset of disabling symptoms. They noticed that an early EMDR session performed within 6 hours of the event that led to the emergency room could reduce post-concussion syndromes and post-traumatic stress disorder by up to 75%.
EMDR: a proven therapeutic approach
EMDR (for “eye movement desensitization and reprocessing”, in French “desensitization and reprocessing by eye movements”) is a psychotherapeutic technique which uses eye movements to erase psychic traumas. She seeks to reprocess the traumatic memory of the past by mobilizing resources from the present to overcome the traumatic nature of the event. It is therefore necessary to mobilize functional neural circuits not disturbed by the emotional overload or the disorder. Essentially used in post-traumatic syndromes, EMDR is very effective following a visit to the emergency room.
During an EMDR session in the emergency room, the patient is thus asked to pay attention to the elements that place him in a state of stress, and to his physical, emotional and sensory feelings. In doing so, the therapist performs series of alternating bilateral stimulation, consisting of eye movements (horizontal or vertical scanning) or, when the clinical condition of the patient does not allow it, alternate tapping of the knees or shoulders.
A possible and effective intervention in the context of emergencies
In total, 130 patients agreed to participate in the study by Inserm researchers. They were then randomly divided into three groups: the first received a 60-minute EMDR session, the second a 15-minute interview with a psychologist while the third did not receive care. psychological.
The patients were then contacted by phone three months later, to identify those who had developed post-concussion syndrome, or post-traumatic stress disorder.
Of the patients who received a 60-minute EMDR session, only 15% suffered from post-concussion syndrome three months later. They were 47% among those who received an interview with a psychologist and 65% among those who received no psychological care. The proportion of patients with post-traumatic stress disorder was 3%, 16% and 19% respectively.
“A brief and ultra-early EMDR intervention is, on the one hand, feasible in the context of emergencies and on the other hand potentially effective”, estimates Emmanuel Lagarde, Inserm research director. However, these results remain to be confirmed by a new, larger study. This was initiated in January 2018 by the same team at the CHUs of Lyon and Bordeaux, with more than 400 patients. Its results will be known before the end of 2018.
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