ABSTRACT

Background: In recent years, eye movement desensitization and reprocessing (EMDR) has been applied to different psychiatric conditions beyond post-traumatic stress disorder (PTSD), and an increasing number of studies have evaluated its effect on depression. To date, no quantitative synthesis of the efficacy of EMDR on depression has been conducted.

Objective: To meta-analytically review the studies on EMDR for depression as the primary target for treatment.

Method: Studies with a controlled design evaluating the effect of EMDR on depression were searched on six electronic databases (PubMed, Embase, CINAHL, PsycINFO, Cochrane database, and Francine Shapiro Library) and then selected by two independent reviewers. A systematic review and meta-analysis was conducted.

Results: Eleven studies were included for qualitative synthesis. Nine studies were included in the meta-analysis, involving 373 participants. The overall effect size of EMDR for depressive symptoms is large (n = 9, Hedges’ g = – 1.07; 95%CI [–1.66; – 0.48]), with high heterogeneity (I² = 84%), and corresponds to a ‘number needed to treat’ of 1.8. At follow-up (range 3–6 months), the effect remains significant but moderate (n = 3, Hedges’ g = – 0.62; 95%CI [–0.97; – 0.28]; I² = 0%). The effect of EMDR compared with active controls is also moderate (n = 7, g = – 0.68; 95%CI [–0.92; – 0.43]; I² = 0%). No publication bias was found, although the results are limited by the small number and poor methodological quality of the included studies.

Conclusions: Review findings suggest that EMDR may be considered an effective treatment for improving symptoms of depression, with effects comparable to other active treatments. However, findings need to be interpreted in light of the limited number of the studies and their quality. Further research is required to understand the longer-term of effects EMDR in treating depression and preventing depression relapse.

Protocol registration: PROSPERO (CRD42018090086).

摘要

背景：近年来，眼动脱敏和再加工（EMDR）已应用于创伤后应激障碍（PTSD）以外的不同精神疾病，并且越来越多的研究评估了其对抑郁症的影响。迄今为止，尚未对 EMDR 对抑郁症的疗效进行定量综合。

目的：荟萃分析回顾以 EMDR 治疗抑郁症作为主要治疗靶点的研究。

方法：在六个电子数据库（PubMed、Embase、CINAHL、PsycINFO、Cochrane 数据库和 Francine Shapiro 图书馆）中搜索了评估 EMDR 对抑郁症影响的受控设计研究，然后由两名独立评审员选择。进行了系统回顾和荟萃分析。

结果：11 项研究被纳入定性综合。荟萃分析包括 9 项研究，涉及 373 名参与者。EMDR 对抑郁症状的整体效应量很大 ( n = 9, Hedges' g = – 1.07; 95%CI [–1.66; – 0.48])，具有高异质性 ( I ²  = 84%)，对应于“需要治疗的人数”为 1.8。在随访期间（范围 3–6 个月），效果仍然显着但适中（n = 3，Hedges' g = – 0.62；95%CI [–0.97；– 0.28]；I ²  = 0%）。与活性对照相比，EMDR 的效果也适中（n = 7，g = – 0.68；95%CI [–0.92；– 0.43]；我²  = 0%)。没有发现发表偏倚，尽管结果受到纳入研究数量少和方法学质量差的限制。

结论：审查结果表明，EMDR 可能被认为是改善抑郁症状的有效治疗方法，其效果可与其他积极治疗相媲美。然而，需要根据有限的研究数量及其质量来解释研究结果。需要进一步的研究来了解 EMDR 在治疗抑郁症和预防抑郁症复发方面的长期效果。

协议注册：PROSPERO (CRD42018090086)。