Hypnosis-based psychodynamic treatment in ALS: a longitudinal study on patients and their caregivers.

• Main Authors: Johann Roland Kleinbub, Arianna ePalmieri, Alice eBroggio, Francesco ePagnini, Benelli eEnrico, Marco eSambin, Gianni eSorarù
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2015-06-01
• Series: Frontiers in Psychology
• Subjects: Amyotrophic Lateral Sclerosis; Anxiety; Depression; Hypnosis; Quality of Life; Defense Mechanisms
• Online Access: http://journal.frontiersin.org/Journal/10.3389/fpsyg.2015.00822/full

Background: Evidence of psychological treatment efficacy is strongly needed in ALS, particularly regarding long-term effects.Methods: Fifteen patients participated in a hypnosis treatment and self-hypnosis training protocol after an in-depth psychological and neurological evaluation. Patients’ primary caregivers and 15 one-by-one matched control patients were considered in the study.Measurements of anxiety, depression and quality of life were collected at the baseline, post-treatment, and after 3 and 6 months from the intervention. Bayesian linear mixed-models were used to evaluate the impact of treatment and defense style on patients’ anxiety, depression, quality of life, and functional impairment (ALSFRS-r), as well as on caregivers’ anxiety and depression.Results: The statistical analyses revealed an improvement in psychological variables’ scores immediately after the treatment. Amelioration in patients’ and caregivers’ anxiety as well as caregivers’ depression, were found to persist at 3 and 6 months follow-ups. The observed massive use of primitive defense mechanisms was found to have a reliable and constant buffer effect on psychopathological symptoms in both patients and caregivers. Notably, treated patients decline in ALSFRS-r score was observed to be slower than that of control group’s patients.Discussion: Our brief psychodynamic hypnosis-based treatment showed efficacy both at psychological and physical levels in patients with ALS, and was indirectly associated to long-lasting benefits in caregivers. The implications of peculiar psychodynamic factors and mind-body techniques are discussed. Future directions should be oriented toward a convergence of our results and further psychological interventions, in order to delineate clinical best practices for ALS.