Comparison of EMDR and CBT as Adjunctive Treatments for Recurrent Depression
Written by: Ostacoli, L., Carletto, S., Cavallo, M., Baldomir-Gago, P., Di Lorenzo, G., Fernandez, I., ... & Hofmann, A. (2018).
Edited by: EMDR-Zone Editorial Team
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EMDR outperformed CBT in symptom reduction, with 71% vs. 48.7% at intervention end, and 54.8% vs. 42.9% at 6-month follow-up.
Introduction and Background
Depression is a pervasive mental health challenge that affects over 300 million individuals worldwide. Recognized by the World Health Organization (WHO) as a primary cause of global disability, depression's impact on individuals and communities cannot be overstated. The condition not only affects the emotional well-being of individuals but also has significant socio-economic implications. While various treatments are available, their effectiveness varies, and there remains a substantial portion of patients who don't respond adequately. Furthermore, the intricate relationship between adverse childhood experiences (ACEs) and recurrent depressive disorders has been increasingly acknowledged, suggesting that trauma-focused interventions might offer a more targeted approach.
The Role of Eye Movement Desensitization Reprocessing (EMDR)
EMDR, developed in the late 1980s, initially aimed to address traumatic memories. Over the years, its application has expanded, and it's now an empirically supported treatment for post-traumatic stress disorder (PTSD). The underlying principle of EMDR is the Adaptive Information Processing (AIP) model. This model posits that distressing events, when not adequately processed, are stored in a dysfunctional manner, leading to various psychological disorders. EMDR facilitates the reprocessing of these memories, making it a potentially revolutionary approach to treating recurrent depression.
EMDR vs. Cognitive Behavioral Therapy (CBT) for Depression
Cognitive Behavioral Therapy (CBT) has long been a cornerstone in the treatment of depression. However, with evolving understanding and methodologies, the study aimed to juxtapose the efficacy of EMDR against CBT, especially in the context of recurrent depression. It's worth noting that both these treatments were adjunctive, meaning they were supplementary to the standard antidepressant medication (ADM) that patients were receiving.
Study Design and Setting
The research was meticulously designed as a non-inferiority, randomized controlled clinical trial. This design was chosen to compare the effectiveness of EMDR and CBT when used alongside ADM. The study spanned two psychiatric services located in Italy and Spain. A total of 82 patients participated, with 40 being allocated to the EMDR group and 42 to the CBT group.
EMDR's Significant Effectiveness Over CBT
The primary metric for success in this study was the rate of depressive symptom remission. This was quantified using the BDI-II score, with a score less than 13 indicating remission. The results were compelling. EMDR demonstrated a clear edge over CBT in symptom reduction: 71% of the EMDR group showed remission at the end of the interventions compared to 48.7% in the CBT group. This trend persisted at the 6-month follow-up, with 54.8% of the EMDR group maintaining remission against 42.9% in the CBT group. These findings underscore EMDR's potential as a more effective treatment modality for recurrent depression.
Conclusion and Implications
While the study's findings are preliminary, they hold significant promise. EMDR emerges as a potentially superior treatment for recurrent depression, especially when one considers its efficacy in addressing traumatic memories. The study also highlighted EMDR's strong association with enhanced brain function and post-traumatic growth, outshining other interventions. This positions EMDR as a promising therapeutic approach for individuals grappling with trauma and recurrent depressive episodes, warranting further exploration and research in the field.
For more detailed information, here is the link for the original article:
https://www.frontiersin.org/articles/10.3389/fpsyg.2018.00074/full
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