Winkler Olga, Dhaliwal Raman, Greenshaw Andrew, O'Shea Katie, Abba-Aji Adam, Chima Chidi, Purdon Scot E, Burback Lisa
Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
Eye Movement Desensitization and Reprocessing International Association, Austin, TX, United States.
JMIR Res Protoc. 2021 Nov 4;10(11):e30711. doi: 10.2196/30711.
Adversity and traumatic experiences increase the likelihood of suicidal thoughts and behaviors. Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based, trauma-focused psychotherapy that desensitizes painful memories, so that reminders in the present no longer provoke overwhelming emotional responses. Preliminary evidence suggests that EMDR can be used as an acute intervention in suicidal patients, including those with major depressive disorder. In addition, because of social distancing restrictions during the COVID-19 pandemic, clinicians have been using EMDR on the web and, in the absence of formal evaluations of web-based EMDR, informal reports indicate good results.
The primary aim of this randomized controlled trial is to investigate whether remotely delivered EMDR (targeting experiences associated with suicidal thinking) reduces suicidal thoughts. Secondary aims include examining the impact of remotely delivered EMDR on symptoms of depression, anxiety, posttraumatic stress, emotional dysregulation, and dissociation. We will also report on adverse events in the EMDR group to explore whether targeting suicidal ideation with EMDR is safe. Finally, we will compare dropout rates between the treatment groups.
In this randomized controlled trial, 80 adults who express suicidal ideation and meet the study criteria will receive either 12 sessions of twice weekly EMDR plus treatment as usual or treatment as usual alone. EMDR sessions will focus on the most distressing and intrusive memories associated with suicidal ideation. Data for primary and secondary objectives will be collected at baseline, 2 months, and 4 months after enrollment. A subsequent longer-term analysis, beyond the scope of this protocol, will examine differences between the groups with respect to the number of posttreatment emergency room visits, hospitalizations, and overall health care use in the year before and after therapy.
The protocol was approved by the University of Alberta Research Health Ethics Board (protocol ID Pro00090989). Funding for this study was provided by the Mental Health Foundation (grant RES0048906). Recruitment started in May 2021, with a projected completion date of March 2023.
The results of this trial will contribute to knowledge on whether web-based delivery of EMDR is a safe and effective treatment for reducing suicidal ideation and potentially reducing the incidence of suicide attempts in this patient population.
ClinicalTrials.gov NCT04181047; https://clinicaltrials.gov/ct2/show/NCT04181047.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/30711.
逆境和创伤经历会增加自杀念头和行为的可能性。眼动脱敏再处理疗法（EMDR）是一种循证的、以创伤为重点的心理治疗方法，可减轻痛苦记忆，使当下的提示不再引发压倒性的情绪反应。初步证据表明，EMDR可作为对自杀患者（包括重度抑郁症患者）的一种急性干预措施。此外，由于2019年冠状病毒病疫情期间的社交距离限制，临床医生一直在网络上使用EMDR，在缺乏对基于网络的EMDR进行正式评估的情况下，非正式报告显示效果良好。
本随机对照试验的主要目的是研究远程提供的EMDR（针对与自杀性思维相关的经历）是否能减少自杀念头。次要目的包括研究远程提供的EMDR对抑郁、焦虑、创伤后应激、情绪失调和解离症状的影响。我们还将报告EMDR组的不良事件，以探讨用EMDR针对自杀意念是否安全。最后，我们将比较治疗组之间的退出率。
在这项随机对照试验中，80名表达自杀意念并符合研究标准的成年人将接受每周两次、共12节的EMDR治疗加常规治疗，或仅接受常规治疗。EMDR治疗将聚焦于与自杀意念相关的最痛苦且侵扰性最强的记忆。主要和次要目标的数据将在入组后的基线、2个月和4个月时收集。超出本方案范围的后续长期分析将研究两组在治疗前后一年的急诊室就诊次数、住院次数和总体医疗保健使用情况方面的差异。
该方案已获得阿尔伯塔大学研究健康伦理委员会批准（方案编号Pro00090989）。本研究的资金由心理健康基金会提供（资助编号RES0048906）。招募工作于2021年5月开始，预计完成日期为2023年3月。
本试验结果将有助于了解基于网络提供EMDR对于减少自杀意念以及可能降低该患者群体自杀未遂发生率是否是一种安全有效的治疗方法。
ClinicalTrials.gov NCT04181047；https://clinicaltrials.gov/ct2/show/NCT04181047。
国际注册报告识别码（IRRID）：DERR1-10.2196/30711。
