Comparison of Eye Movement Desensitization Reprocessing and Cognitive Behavioral Therapy as Adjunctive Treatments for Recurrent Depression: The European Depression EMDR Network (EDEN) Randomized Controlled Trial

Abstract

Background: 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.Objectives: To investigate the efficacy of Eye Movement Desensitization and Reprocessing therapy (EMDR) in addition to antidepressant medication (ADM) in treating recurrent depression.Design: 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.Setting: Two psychiatric services, one in Italy and one in Spain.Participants: Eighty-two patients were randomized with a 1:1 ratio to the EMDR group (n = 40) or CBT group (n = 42). Sixty-six patients, 31 in the EMDR group and 35 in the CBT group, were included in the completers analysis. Intervention: 15 ± 3 individual sessions of EMDR or CBT, both in addition to ADM. Participants were followed up at 6-months.Main outcome measure: Rate of depressive symptoms remission in both groups, as measured by a BDI-II score <13.Results: 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 [F(6,59) = 22.501, p < 0.001] and a significant interaction effect between time and group [F(6,59) = 3.357, p = 0.006], with lower BDI-II scores in the EMDR group at T1 [mean difference = –7.309 (95% CI [–12.811, –1.806]), p = 0.010]. The RM-ANOVA on secondary outcome measures showed similar improvement over time in both groups [F(14,51) = 8.202, p < 0.001], with no significant differences between groups [F(614,51) = 0.642, p = 0.817].Conclusion: 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. Trial registration: ISRCTN09958202.

Neurobiological features and response to eye movement desensitization and reprocessing treatment of posttraumatic stress disorder in patients with breast cancer

“…Furthermore, in the present study, only EMDR was found to be effective in reducing depressive symptoms, as previously demonstrated in other patient groups (Carletto et al, 2017;Chen et al, 2014;Ostacoli et al, 2018).…”

Effectiveness of trauma-focused treatment for adolescents with major depressive disorder

“…In the past 5 years, several studies have been conducted demonstrating preliminary evidence for the efficacy of EMDR therapy in the treatment of MDD in adults. Promising results were obtained from studies investigating EMDR therapy as an adjacent therapy to CBT (Hofmann et al, 2014), to pharmacological treatment (Minelli et al, 2019;Ostacoli et al, 2018) and to inpatient treatment (Hase et al, 2015(Hase et al, , 2018. Three studies, investigating the efficacy of EMDR as a stand-alone treatment, demonstrated significant reductions of depressive symptoms (Gauhar, 2016), even for patients with long-term depression (Wood, Ricketts, & Parry, 2018) and treatment-resistant depression (Minelli et al, 2019).…”

Eye Movement Desensitization and Reprocessing (Emdr) Treatment in Social Anxiety Disorder: A Case Report

“…Much as EMDR is a proven psychotherapeutic approach in posttraumatic stress disorder, there are studies about efficiency in some other psychiatric disorders (Banerjee & Argaez 2017). In addition it can be conducted on various cases in addition to other treatments such as medication or another therapy (Ostacoli et al 2018).…”