Cambodia - Trial Shows Promise of New PTSD Treatment

A new treatment designed to stabilize those with post-traumatic stress disorder (PTSD) has pro­v­en highly effective and could be used to help the roughly quarter of Cambodians who have the mental illness, according to a new study.

A randomized trial of 84 Phnom Penh-area PTSD patients, whose results were published in the World Psychiatry journal last month, assessed whether a treatment plan developed specifically for Cambodia could reduce symptoms of the illness over the course of five therapy sessions.

Patients who underwent the treatment, dubbed Rotate, “achieved a very large reduction in PTSD symptoms” compared to members of a control group, according to study author Christiane Steinert, a research­er at the Clinic for Psychosomatic Medicine and Psychotherapy at Giessen University in Germany.

The study determined that if 100 people were to undergo the new treatment, 75 of them would experience more positive results than if they had received the control treatment, an encouraging result for researchers.

“It is a promising treatment approach that can…easily be implemented locally,” Dr. Steinert said in an email on Thursday.

The test patients were guided through five therapy sessions led by Cambodian therapists, who drew on techniques designed to stabilize symptoms rather than cure PTSD. In some cases, that treatment included eye movement desensitization and reprocessing, or EMDR, in which therapists invoke traumatic memories while simultaneously guiding patients through eye movement exercises, tapping routines or other physical stimulation.

Patients were screened for symptoms of PTSD before and after the treatment using the Harvard Trauma Questionnaire.

The 2012 to 2014 study describes Cambodia’s current mental health treatment options as “insufficient,” but says the local therapists involved in the new study were able to meaningfully connect with their patients.

“Therapists and patients had similar cultural backgrounds…a factor that has been identified as vital in the therapeutic work with Cambodian patients,” the study says.

A separate study cited in the paper estimates that more than half of all Cambodians have mental health illnesses, with over 28 percent experiencing PTSD’s noxious mix of flash­backs, vivid nightmares and hyper-aroused emotional states.

Another study by the U.S. National Institute of Mental Health in 2005 found that more than 60 percent of Cambodian immigrants in the U.S. experienced symptoms of PTSD over the previous year, a rate 17 times higher than that of Americans in general—which the institute linked to the Cambodians’ experiences under the Khmer Rouge.

But among patients in the new study, the most common causes of the disorder were traffic accidents, domestic violence and sexual abuse.

“Many [traumatic] things happen here—not just in the past, but daily, every day. They happen a lot,” said Om Plaktin, president of EMDR Cambodia, the NGO behind the Mekong II Project, from which Rotate researchers drew patients and therapists.

“People don’t know much about psychology,” Mr. Plaktin said on Thursday. “They don’t know how to protect themselves.”

He said the results of the new study had served to galvanize the Mekong II Project, which launched in November 2014 with the goal of treating 1,250 PTSD patients over two years using many of the EMDR and stabilization techniques involved in the study.

EMDR, he said, could be taught to therapists and even non-professionals to expand the reach of treatment and “answer the country’s need.”

Ben Paviour

cambodiadaily