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소방공무원에서 부분 외상후 스트레스 장애의 심리적특성 및 기능적 자기공명영상 특징과 안구운동민감소실 및 재처리요법을 이용한 치료효과

The Psychological Characteristics and Functional Magnetic Resonance Imaging Findings in Firefighters with Partial Posttraumatic Stress Disorder and the Effect of Treatment by Using Eye Movement Desensitization and Reprocessing

김석현|권준수|김남희|김준기|김대호|정위훈|장준환|오동훈|배재현|정용호|신다정|조강익
대한신경정신의학회 (Korean Neuropsychiatric Association)|2014.03|신경정신의학 (JOURNAL OF THE KOREAN NEUROPSYCHIATRIC ASSOCIATION)|제53권 제2호|pp. 122-133

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키워드

소방공무원기능적 자기공명영상측두엽Functional magnetic resonance imagingFirefightersEye movement desensitization and reprocessing부분 외상후 스트레스 장애후두엽안구운동 민감소실 및 재처리요법Partial posttraumatic stress disorderOccipital lobeTemporal lobe
주제분류정신과학

초록

소방공무원에서 부분 PTSD의 진단율이 높고, 이들은 다른 심리적 특성과 생물학적 특징을 보이며 EMDR 치료로 유의미한 호전을 보였다. 향후 이러한 소방공무원의 PTSD와이에 대한 효과적인 정신과적 개입을 위한 관심과 연구가 지속적으로 이루어져야 하며, 이는 양질의 체계적이고 효과적인 정신과적 치료와 정신건강 서비스를 소방공무원들에게제공하기 위한 체계 수립과 정책 개발에 도움이 될 것이다.

Abstract

Objectives This study investigated the clinical characteristics and functional magnetic resonanceimaging (fMRI) findings of firefighters suffering from partial posttraumatic stress disorder(partial PTSD). They were treated by eye movement desensitization and reprocessing (EMDR)and the treatment effect was evaluated. Methods A total of 116 firefighters were screened and 15 of them were diagnosed as partialPTSD. 1) We compared sociodemographic and psychological characteristics between the firefighterpartial PTSD group and the firefighter control group. 2) Subjects in the firefighter partialPTSD group (n=10), firefighter control group (n=8), and general control group (n=12) underwentfMRI with traumatic, negative, positive, and neutral picture stimuli. We compared clinical characteristicsand fMRI findings among these three groups. 3) Seven firefighters in the partial PTSD groupwere treated by EMDR and the treatment effect was evaluated according to psychological scales. Results In fMRI analysis, there was a left middle temporal/occipital activation in the order of thegeneral control group, firefighter control group, than the firefighter partial PTSD group for the Traumatic-Baseline contrast. For the Negative-Baseline contrast, there was an increased left middletemporal/occipital activation in the general control group versus decreased activation in the firefightercontrol group and the firefighter partial PTSD group. All firefighters in the partial PTSD grouptreated by EMDR showed significant improvement of Clinician-Administered PTSD Scale scores. Conclusion These results show high incidence rate of partial PTSD in firefighters. In addition,partial PTSD firefighters exhibited distinct clinical characteristics and fMRI findings and showed significant improvement by EMDR treatment.

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