Zhongguo quanke yixue (Feb 2023)
Eye Movement Desensitization and Reprocessing versus Sertraline in the Treatment of Depressed Adolescents with Childhood Trauma
Abstract
Background Depressed adolescents with childhood trauma often present with more severe symptoms and are insensitive to drugs. Eye movement desensitization and reprocessing (EMDR) plays a unique role in the treatment of trauma-related mental disorders. It has been gradually used in the treatment of depression and has achieved certain results recently, but there are few related studies in China. Objective To assess whether EMDR has better efficacy than sertraline in the treatment of depressed adolescents with childhood trauma using a comparative analysis, providing scientific evidence for further promoting clinical application of EMDR. Methods Sixty depressed adolescents with childhood trauma were recruited from Psychological Clinic, Affiliated Hospital of Zunyi Medical University from December 2020 to February 2022, and equally randomized into a sertraline group and an EMDR group. Sertraline group received a eight-week treatment with sertraline: the dose was 50 mg/d in the first week and gradually increased to 100 mg/d in the second week, and could be increased to 200 mg/d at the end of the fourth week if the patients had negative ideas or self-injurious behavior. The EMDR group received EMDR treatment, once a week, for a total of 8 weeks. The Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Connor-Davidson Resilience Scale (CD-RISC) were used to evaluate the psychological status of the two groups before treatment, four weeks and eight weeks after treatment. Results Except for five dropouts, the remaining cases who completed the trial were finally included, including 28 in the sertraline group and 27 in the EMDR group. The treatment type and treatment duration had interactive effects on the BDI, BAI and CD-RISC scores of the two groups (P<0.05). The treatment duration had significant main effects on the BDI, BAI and CD-RISC scores of the two groups (P<0.05). The treatment type had significant main effects on BAI and CD-RISC scores of the two groups (P<0.05), but produced no significant effects on the BDI scores (P>0.05). EMDR group had higher average CD-RISC score than sertraline group at four weeks after treatment (P<0.05). EMDR group had higher average CD-RISC score, and lower average BDI and BAI scores than sertraline group at eight weeks after treatment (P<0.05). In the sertraline group, the average BDI score at eight weeks after treatment was much lower than that at baseline or four weeks after treatment (P<0.05), the BDI score after 4 weeks of sertraline treatment was lower than that before treatment (P<0.05), and the average BAI score at eight weeks after treatment was much lower than that at basetime (P<0.05). In the EMDR group, the average BDI and BAI scores decreased significantly while the average CD-RISC score increased significantly at both four and eight weeks after treatment compared with baseline levels (P<0.05). And compared with four-week treatment, eight-week treatment lowered the average BDI and BAI scores more significantly, and increased the average CD-RISC score more significantly (P<0.05) . Conclusion Sertraline could partially improve depression and anxiety in depressed adolescents with childhood trauma, but had no significant improvement of psychological elasticity. In contrast, EMDR could effectively improve the depression and anxiety as well as psychological elasticity, so it could be used as the preferred treatment.
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