Burback Lisa, Yap Sidney, Purdon Scot E, Abba-Aji Adam, O'Shea Katie, Brémault-Phillips Suzette, Greenshaw Andrew J, Winkler Olga
Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
Alberta Hospital Edmonton, Edmonton, AB, Canada.
Front Psychiatry. 2024 Feb 16;15:1361086. doi: 10.3389/fpsyt.2024.1361086. eCollection 2024.
Promising preliminary evidence suggests that EMDR may reduce suicidal ideation (SI) when used to treat Major Depressive Disorder, Posttraumatic Stress Disorder, and trauma symptoms in the context of acute mental health crises. EMDR has never been tested specifically for treating SI, and there is a lack of data regarding the safety and effectiveness of web-based, therapist-delivered EMDR in populations with known SI. The primary objective of this study was to investigate the impact of web-based, therapist-delivered EMDR, targeting experiences associated with suicidal thinking. Secondary objectives included examining the effect of EMDR treatment on symptoms of depression, anxiety, posttraumatic stress, emotional dysregulation, and dissociation, as well as safety and attrition.
This randomized control trial (ClinicalTrials.gov ID number: NCT04181047) assigned adult outpatients reporting SI to either a web-based EMDR intervention or a treatment as usual (TAU) group. TAU included primary and mental health services available within the Canadian public health system. Participants in the EMDR group received up to 12 web-based EMDR desensitization sessions, delivered twice weekly during the COVID-19 pandemic (2021-2023). The Health Research Ethics Board at the University of Alberta approved the protocol prior to initiation of data collection for this study (protocol ID number: Pro00090989).
Forty-two adult outpatients received either EMDR (n=20) or TAU (n=22). Participants reported a high prevalence of early onset and chronic SI, and there was a high rate of psychiatric comorbidity. In the EMDR group, median SI, depression, anxiety, and posttraumatic symptom scale scores decreased from baseline to the four month follow-up. In the TAU group, only the median SI and posttraumatic symptom scale scores decreased from baseline to four month follow up. Although sample size precludes direct comparison, there were numerically fewer adverse events and fewer dropouts in the EMDR group relative to the TAU group.
Study results provide promising preliminary evidence that web-based EMDR may be a viable delivery approach to address SI. In this complex population, a short treatment course was associated with reductions of SI and other symptoms across multiple diagnostic categories. Further investigation is warranted to verify and extend these results.
https://clinicaltrials.gov/study/NCT04181047?id=NCT04181047&rank=1, identifier NCT04181047.
有前景的初步证据表明，当眼动脱敏再处理疗法（EMDR）用于治疗重度抑郁症、创伤后应激障碍以及急性心理健康危机背景下的创伤症状时，可能会减少自杀意念（SI）。EMDR从未专门针对治疗自杀意念进行过测试，并且缺乏关于基于网络、由治疗师提供的EMDR在已知有自杀意念人群中的安全性和有效性的数据。本研究的主要目的是调查基于网络、由治疗师提供的EMDR针对与自杀性思维相关经历的影响。次要目的包括检查EMDR治疗对抑郁、焦虑、创伤后应激、情绪失调和解离症状的影响，以及安全性和损耗情况。
这项随机对照试验（ClinicalTrials.gov识别号：NCT04181047）将报告有自杀意念的成年门诊患者分配到基于网络的EMDR干预组或常规治疗（TAU）组。常规治疗包括加拿大公共卫生系统内提供的初级和心理健康服务。EMDR组的参与者接受了多达12次基于网络的EMDR脱敏治疗，在2019-2023年新冠疫情期间每周进行两次。阿尔伯塔大学健康研究伦理委员会在本研究开始数据收集之前批准了该方案（方案识别号：Pro00090989）。
42名成年门诊患者接受了EMDR治疗（n = 20）或常规治疗（n = 22）。参与者报告早期发作和慢性自杀意念的患病率较高，并且精神共病率也很高。在EMDR组中，从基线到四个月随访时，自杀意念、抑郁、焦虑和创伤后症状量表评分的中位数有所下降。在常规治疗组中，只有自杀意念和创伤后症状量表评分的中位数从基线到四个月随访时有所下降。尽管样本量不足以进行直接比较，但与常规治疗组相比，EMDR组在数值上不良事件和退出人数较少。
研究结果提供了有前景的初步证据，表明基于网络的EMDR可能是一种可行的解决自杀意念的治疗方法。在这个复杂的人群中，一个简短的治疗疗程与多个诊断类别中的自杀意念和其他症状的减少相关。有必要进行进一步的调查以验证和扩展这些结果。
https://clinicaltrials.gov/study/NCT04181047?id=NCT04181047&rank=1，识别号NCT04181047
