Ostacoli Luca, Carletto Sara, Cavallo Marco, Baldomir-Gago Paula, Di Lorenzo Giorgio, Fernandez Isabel, Hase Michael, Justo-Alonso Ania, Lehnung Maria, Migliaretti Giuseppe, Oliva Francesco, Pagani Marco, Recarey-Eiris Susana, Torta Riccardo, Tumani Visal, Gonzalez-Vazquez Ana I, Hofmann Arne
Clinical and Biological Sciences Department, University of Turin, Turin, Italy.
Clinical and Oncological Psychology, Città della Salute e della Scienza Hospital of Turin, Turin, Italy.
Front Psychol. 2018 Feb 13;9:74. doi: 10.3389/fpsyg.2018.00074. eCollection 2018.
Treatment of recurrent depressive disorders is currently only moderately successful. Increasing evidence suggests a significant relationship between adverse childhood experiences and recurrent depressive disorders, suggesting that trauma-based interventions could be useful for these patients. To investigate the efficacy of Eye Movement Desensitization and Reprocessing therapy (EMDR) in addition to antidepressant medication (ADM) in treating recurrent depression. A non-inferiority, single-blind, randomized clinical controlled trial comparing EMDR or CBT as adjunctive treatments to ADM. Randomization was carried out by a central computer system. Allocation was carried out by a study coordinator in each center. Two psychiatric services, one in Italy and one in Spain. Eighty-two patients were randomized with a 1:1 ratio to the EMDR group ( = 40) or CBT group ( = 42). Sixty-six patients, 31 in the EMDR group and 35 in the CBT group, were included in the completers analysis. 15 ± 3 individual sessions of EMDR or CBT, both in addition to ADM. Participants were followed up at 6-months. : Rate of depressive symptoms remission in both groups, as measured by a BDI-II score <13. Sixty-six patients were analyzed as completers (31 EMDR vs. 35 CBT). No significant difference between the two groups was found either at the end of the interventions (71% EMDR vs. 48.7% CBT) or at the 6-month follow-up (54.8% EMDR vs. 42.9% CBT). A RM-ANOVA on BDI-II scores showed similar reductions over time in both groups [(6,59) = 22.501, < 0.001] and a significant interaction effect between time and group [(6,59) = 3.357, = 0.006], with lower BDI-II scores in the EMDR group at T1 [mean difference = -7.309 (95% CI [-12.811, -1.806]), 0.010]. The RM-ANOVA on secondary outcome measures showed similar improvement over time in both groups [(14,51) = 8.202, < 0.001], with no significant differences between groups [(614,51) = 0.642, = 0.817]. Although these results can be considered preliminary only, this study suggests that EMDR could be a viable and effective treatment for reducing depressive symptoms and improving the quality of life of patients with recurrent depression.
ISRCTN09958202.
目前，复发性抑郁症的治疗效果仅为中等程度成功。越来越多的证据表明，童年不良经历与复发性抑郁症之间存在显著关联，这表明基于创伤的干预措施可能对这些患者有用。为了研究眼动脱敏再处理疗法（EMDR）联合抗抑郁药物（ADM）治疗复发性抑郁症的疗效。一项非劣效性、单盲、随机临床对照试验，比较EMDR或认知行为疗法（CBT）作为ADM辅助治疗的效果。随机分组由中央计算机系统进行。每个中心的研究协调员负责分配。两个精神科服务机构，一个在意大利，一个在西班牙。82名患者按1:1比例随机分为EMDR组（n = 40）或CBT组（n = 42）。66名患者纳入完成者分析，其中EMDR组31名，CBT组35名。除ADM外，进行15±3次个体EMDR或CBT治疗。对参与者进行6个月的随访。指标：两组抑郁症状缓解率，以贝克抑郁量表第二版（BDI-II）评分<13衡量。对66名患者作为完成者进行分析（31名接受EMDR治疗与35名接受CBT治疗）。在干预结束时（EMDR组为71%，CBT组为48.7%）或6个月随访时（EMDR组为54.8%，CBT组为42.9%），两组之间均未发现显著差异。对BDI-II评分进行重复测量方差分析显示，两组随时间推移均有类似程度的降低[F(6,59) = 22.501，p < 0.001]，且时间与组间存在显著交互作用[F(6,59) = 3.357，p = 0.006]，在T1时EMDR组的BDI-II评分较低[平均差异 = -7.309（95%置信区间[-12.811，-1.806]），p = 0.010]。对次要结局指标进行的重复测量方差分析显示，两组随时间推移均有类似改善[F(14,51) = 8.202，p < 0.001]，组间无显著差异[F(614,51) = 0.642，p = 0.817]。尽管这些结果仅可视为初步结果，但本研究表明，EMDR可能是一种可行且有效的治疗方法，可减轻复发性抑郁症患者的抑郁症状并改善其生活质量。
ISRCTN09958202
