Eficacia del EMDR en el Trastorno de Estrés Post-traumáticouna Revisión Sistemática y Meta-análisis de Ensayos Clínicos Aleatorizados

  1. Pedro Rasines-Laudes 1
  2. Isabel Serrano-Pintado 2
  1. 1 Red de Salud Mental de Bizkaia
  2. 2 Universidad de Salamanca
    info

    Universidad de Salamanca

    Salamanca, España

    ROR https://ror.org/02f40zc51

Revista:
Psicothema

ISSN: 0214-9915,  1886-144X

Año de publicación: 2023

Volumen: 35

Número: 4

Páginas: 385-396

Tipo: Artículo

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Otras publicaciones en: Psicothema

Resumen

En los últimos años la desensibilización y reprocesamiento por movimientos oculares (EMDR) se está extendiendo tanto en su número de publicaciones como de profesionales que utilizan esta técnica en el ámbito clínico. El presente meta-análisis tiene como objetivo comprobar la eficacia del EMDR en el tratamiento del trastorno de estrés post-traumático. Método: A partir de los criterios de inclusión/exclusión fueron seleccionados 18 artículos (n = 1213 sujetos), entre los años 1991-2022. Resultados: Los tamaños del efecto hallados en el meta-análisis fueron pequeños en la reducción de síntomas asociados al TEPT, ansiosos y depresivos, tanto en el pos-tratamiento como en el mantenimiento. El análisis de las variables moderadoras reveló que el tiempo de intervención, el número y la duración de las sesiones, la veteranía del terapeuta y el tipo de terapeuta encargado de la intervención juegan un papel importante en el tamaño del efecto final. No se encontraron datos estadísticamente significativos en el análisis de la metarregresión. Conclusiones: Sin embargo, aunque el estudio cuenta con criterios restrictivos en cuanto a la selección de los estudios, existe cierto riesgo de sesgo en los artículos seleccionados que carecen de una calidad metodológica suficiente para ser extrapolados al ámbito clínico.

Referencias bibliográficas

  • (The studies marked with an asterisk were included in the meta-analysis)
  • *Acarturk, C., Konuk, E., Cetinkaya, M., Senay, I., Sijbrandij, M., Gulen, B., & Cuijpers, P. (2016). The efficacy of eye movement desensitization and reprocessing for post-traumatic stress disorder and depression among Syrian refugees: Results of a randomized controlled trial. Psychological Medicine, 46(12), 2583-2593. https://doi.org/10.1017/S0033291716001070
  • American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (fifth edition). American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425596
  • *Boterhoven De Haan, K. L., Lee, C. W., Fassbinder, E., Van Es, S. M., Menninga, S., Meewisse, M.-L., Rijkeboer, M., Kousemaker, M., & Arntz, A. (2020). Imagery rescripting and eye movement desensitisation and reprocessing as treatment for adults with post-traumatic stress disorder from childhood trauma: Randomised clinical trial. British Journal of Psychiatry, 217(5), 609-615. https://doi.org/10.1192/BJP.2020.158
  • Bradley, R., Greene, J., Russ, E., Dutra, L., & Westen, D. (2005). A multidimensional meta-analysis of psychotherapy for PTSD. The American Journal of Psychiatry, 162(2), 214-227. https://doi.org/10.1176/appi.ajp.162.2.214
  • *Carlson, J. G., Chemtob, C. M., Rusnak, K., Hedlund, N. L., & Muraoka, M. Y. (1998). Eye movement desensitization and reprocessing (EDMR) treatment for combat-related posttraumatic stress disorder. Journal of Traumatic Stress, 11(1), 3-24. https://doi.org/10.1023/A:1024448814268
  • Chen, Y.-R., Hung, K.-W., Tsai, J.-C., Chu, H., Chung, M.-H., Chen, S.-R., Liao, Y.-M., Ou, K.-L., Chang, Y.-C., & Chou, K.-R. (2014). Efficacy of eye-movement desensitization and reprocessing for patients with posttraumatic-stress disorder: A meta-analysis of randomized controlled trials. PLoS ONE, 9(8), Article e103676. https://doi.org/10.1371/journal.pone.0103676
  • Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20, 37–46. https://doi.org/10.1177/001316446002000104
  • Cuijpers, P., van Veen, S. C., Sijbrandij, M., Yoder, W., & Cristea, I. A. (2020). Eye movement desensitization and reprocessing for mental health problems: A systematic review and meta-analysis. Cognitive Behaviour Therapy, 49(3), 165-180. https://doi.org/10.1080/16506073.2019.1703801
  • Cusack, K., Jonas, D. E., Forneris, C. A., Wines, C., Sonis, J., Middleton, J. C., Feltner, C., Brownley, K. A., Olmsted, K. R., Greenblatt, A., Weil, A., & Gaynes, B. N. (2016). Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta-analysis). Clinical Psychology Review, 43, 128-141. https://doi.org/10.1016/j.cpr.2015.10.003
  • *Devilly, G. J., & Spence, S. H. (1999). The relative efficacy and treatment distress of EMDR and a cognitive- behavior trauma treatment protocol in the amelioration of Posttraumatic Stress Disorder. Journal of Anxiety Disorders, 13(1-2), 131-157. https://doi.org/10.1016/S0887-6185(98)00044-9
  • Ehring, T., Welboren, R., Morina, N., Wicherts, J. M., Freitag, J., & Emmelkamp, P. M. G. (2014). Meta-analysis of psychological treatments for posttraumatic stress disorder in adult survivors of childhood abuse. Clinical Psychology Review, 34(8), 645-657. https://doi.org/10.1016/j.cpr.2014.10.004
  • Grissom, R. J., & Kim, J. J. (2005). Effect sizes for research: A broad practical approach. Lawrence Erlbaum Associates Publishers. https://doi.org/10.4324/9781410612915
  • Haagen, J. F. G., Smid, G. E., Knipscheer, J. W., & Kleber, R. J. (2015). The efficacy of recommended treatments for veterans with PTSD: A metaregression analysis. Clinical Psychology Review, 40, 184-194. https://doi.org/10.1016/j.cpr.2015.06.008
  • Higgins, J. P. T., Altman, D. G., Gøtzsche, P. C., Jüni, P., Moher, D., Oxman, A. D., Savović, J., Schulz, K. F., Weeks, L., & Sterne, J. A. C. (2011). The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ, 343, Article d5928. https://doi.org/10.1136/bmj.d5928
  • *Högberg, G., Pagani, M., Sundin, Ö., Soares, J., Åberg-Wistedt, A., Tärnell, B., & Hällström, T. (2007). On treatment with eye movement desensitization and reprocessing of chronic post-traumatic stress disorder in public transportation workers – A randomized controlled trial. Nordic Journal of Psychiatry, 61(1), 54-61. https://doi.org/10.1080/08039480601129408
  • *Högberg, G., Pagani, M., Sundin, O., Soares, J., Aberg-Wistedt, A., Tärnell, B., & Hällström, T. (2008). Treatment of post-traumatic stress disorder with eye movement desensitization and reprocessing: Outcome is stable in 35-month follow-up. Psychiatry Research, 159(1-2), 101-108. https://doi.org/10.1016/j.psychres.2007.10.019
  • Institute of Medicine. (2008). Treatment of posttraumatic stress disorder: An assessment of the evidence. The National Academies Press. https://doi.org/10.17226/11955.
  • *Ironson, G., Freund, B., Strauss, J. L., & Williams, J. (2002). Comparison of two treatments for traumatic stress: A community-based study of EMDR and prolonged exposure. Journal of Clinical Psychology, 58(1), 113-128. https://doi.org/10.1002/JCLP.1132
  • Jadad, A. R., Moore, R. A., Carroll, D., Jenkinson, C., Reynolds, D. J. M., Gavaghan, D. J., & McQuay, H. J. (1996). Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Controlled Clinical Trials, 17(1), 1-12. https://doi.org/10.1016/0197-2456(95)00134-4
  • *Karatzias, T., Power, K., Brown, K., McGoldrick, T., Begum, M., Young, J., Loughran, P., Chouliara, Z., & Adams, S. (2011). A controlled comparison of the effectiveness and efficiency of two psychological therapies for posttraumatic stress disorder: Eye movement desensitization and reprocessing vs. emotional freedom techniques. The Journal of Nervous and Mental Disease, 199(6), 372-378. https://doi.org/10.1097/NMD.0b013e31821cd262
  • Khan, A. M., Dar, S., Ahmed, R., Bachu, R., Adnan, M., & Kotapati, V. P. (2018). Cognitive behavioral therapy versus eye movement desensitization and reprocessing in patients with post-traumatic stress disorder: Systematic review and meta-analysis of randomized clinical trials. Cureus, 10(9), Article e3250. https://doi.org/10.7759/cureus.3250
  • *Lee, C., Gavriel, H., Drummond, P., Richards, J., & Greenwald, R. (2002). Treatment of PTSD: Stress inoculation training with prolonged exposure compared to EMDR. Journal of Clinical Psychology, 58(9), 1071-1089. https://doi.org/10.1002/JCLP.10039
  • Marín, C., Guillén, A. I., & Vergara, S. (2016). Nacimiento, desarrollo y evolución de la desensibilización y el reprocesamiento por medio de movimientos oculares (EMDR). [Birth, development and evolution of eye movement desensitization and reprocessing (EMDR).] Clínica y Salud, 27(3), 101-114. https://doi.org/10.1016/j.clysa.2016.09.001
  • *McGuire Stanbury, T. M., Drummond, P. D., Laugharne, J., Kullack, C., & Lee, C. W. (2020). Comparative efficiency of EMDR and prolonged exposure in treating posttraumatic stress disorder: A randomized trial. Journal of EMDR Practice and Research, 14(1), 2-12. https://doi.org/10.1891/1933-3196.14.1.2
  • MedCalc: MedCalc’s Relative risk calculator. MedCalc Software Ltd. (2023). https://www.medcalc.org/calc/relative_risk.php.
  • Morina, N., Hoppen, T. H., & Kip, A. (2021). Study quality and efficacy of psychological interventions for posttraumatic stress disorder: A metaanalysis of randomized controlled trials. Psychological Medicine, 51(8), 1260-1270. https://doi.org/10.1017/S0033291721001641
  • Novo Navarro, P., Landin-Romero, R., Guardiola-Wanden-Berghe, R., Moreno-Alcázar, A., Valiente-Gómez, A., Lupo, W., García, F., Fernández, I., Pérez, V., & Amann, B. L. (2018). 25 years of Eye Movement Desensitization and Reprocessing (EMDR): The EMDR therapy protocol, hypotheses of its mechanism of action and a systematic review of its efficacy in the treatment of post-traumatic stress disorder. 25 años de Eye Movement Desensitization and Reprocessing: protocolo de aplicación, hipótesis de funcionamiento y revisión sistemática de su eficacia en el trastorno por estrés postraumático. Revista de psiquiatria y salud mental, 11(2), 101–114. https://doi.org/10.1016/j.rpsm.2015.12.002
  • *Nijdam, M. J., Gersons, B. P. R., Reitsma, J. B., de Jongh, A., & Olff, M. (2012). Brief eclectic psychotherapy v. eye movement desensitisation and reprocessing therapy for post-traumatic stress disorder: Randomised controlled trial. The British Journal of Psychiatry: The Journal of Mental Science, 200(3), 224-231. https://doi.org/10.1192/bjp.bp.111.099234
  • *Nijdam, M. J., van der Meer, C. A. I., van Zuiden, M., Dashtgard, P., Medema, D., Qing, Y., Zhutovsky, P., Bakker, A., & Olff, M. (2018). Turning wounds into wisdom: Posttraumatic growth over the course of two types of trauma-focused psychotherapy in patients with PTSD. Journal of Affective Disorders, 227, 424-431. https://doi.org/10.1016/j.jad.2017.11.031
  • Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Aki, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S.,Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. PLOS Medicine, 18(3), Article e1003583. https://doi.org/10.1371/journal.pmed.1003583
  • Pérez Álvarez, M. (2021). Ciencia y pseudociencia en psicología y psiquiatría [Science and pseudoscience in psychology and psychiatry]. Alianza Editorial.
  • *Power, K., McGoldrick, T., Brown, K., Buchanan, R., Sharp, D., Swanson, V., & Karatzias, A. (2002). A controlled comparison of eye movement desensitization and reprocessing versus exposure plus cognitive restructuring versus waiting list in the treatment of post-traumatic stress disorder. Clinical Psychology and Psychotherapy, 9(5), 299-318. https://doi.org/10.1002/CPP.341
  • *Rogers, S., Silver, S. M., Goss, J., Obenchain, J., Willis, A., & Whitney, R. L. (1999). A single session, group study of exposure and eye movement desensitization and reprocessing in treating posttraumatic stress disorder among Vietnam war veterans: Preliminary data. Journal of Anxiety Disorders, 13(1-2), 119-130. https://doi.org/10.1016/S0887-6185(98)00043-7
  • Rosa Garrido M. C. (2016). Sesgo de publicación: ¿existe también en estudios de metanálisis? [Publication bias: does it also exist in meta-analysis studies?] Index de Enfermería, 25(1-2), 7-8. http://scielo.isciii.es/scielo. php?script=sci_arttext&pid=S1132-12962016000100002&lng=es
  • Rosenthal, R. (1991). Meta-Analytic pocedures for social research (Vol. 6). SAGE Publications, Inc. https://doi.org/10.4135/9781412984997
  • Rosenthal, R., & Rubin, D. B. (1988). Selection models and the file drawer problem: Comment: Assumptions and procedures in the file drawer problem. Statistical Science, 3(1), 120-125. https://doi.org/10.1214/ss/1177013014
  • *Rothbaum, B. O., Astin, M. C., & Marsteller, F. (2005). Prolonged exposure versus eye movement desensitization and reprocessing (EMDR) for PTSD rape victims. Journal of Traumatic Stress, 18(6), 607-616. https://doi.org/10.1002/JTS.20069
  • Schumemann, H., Brożek, J., Guyatt, G. and Oxman, A. (2013). GRADE Handbook. Grading of recommendations assessment, development and evaluation, Grade Working Group. http://gdt.guidelinedevelopment.org/central_prod/_design/client/handbook/handbook.html
  • *Taylor, S., Thordarson, D. S., Maxfield, L., Fedoroff, I. C., Lovell, K., & Ogrodniczuk, J. (2003). Comparative efficacy, speed, and adverse effects of three PTSD treatments: Exposure therapy, EMDR, and relaxation training. Journal of Consulting and Clinical Psychology, 71(2), 330-338. https://doi.org/10.1037/0022-006X.71.2.330
  • *Ter Heide, F. J. J., Mooren, T. M., van de Schoot, R., de Jongh, A., & Kleber, R. J. (2016). Eye movement desensitisation and reprocessing therapy v. stabilisation as usual for refugees: Randomised controlled trial. The British Journal of Psychiatry, 209(4), 311-318. https://doi.org/10.1192/bjp.bp.115.167775
  • The Cochrane Collaboration (2020). Review manager 5.4[Computer program]. https://training.cochrane.org/online-learning/core-software/revman
  • Thompson, C. T., Vidgen, A., & Roberts, N. P. (2018). Psychological interventions for post-traumatic stress disorder in refugees and asylum seekers: A systematic review and meta-analysis. Clinical Psychology Review, 63, 66-79. https://doi.org/10.1016/j.cpr.2018.06.006
  • *van der Kolk, B. A., Spinazzola, J., Blaustein, M. E., Hopper, J. W., Hopper, E. K., Korn, D. L., & Simpson, W. B. (2007). A randomized clinical trial of eye movement desensitization and reprocessing (EMDR), fluoxetine, and pill placebo in the treatment of posttraumatic stress disorder: Treatment effects and long-term maintenance. The Journal of Clinical Psychiatry, 68(1), 37-46. https://doi.org/10.4088/JCP.v68n0105
  • Van Rhee, H.J., Suurmond, R., & Hak, T. (2015). User manual for metaessentials: Workbooks for meta-analysis (Version 1.4). Rotterdam, The Netherlands: Erasmus Research Institute of Management. https://www.erim.eur.nl/research-support/meta-essentials
  • *van Vliet, N. I., Huntjens, R. J. C., van Dijk, M. K., Bachrach, N., Meewisse, M.-L., & de Jongh, A. (2021). Phase-based treatment versus immediate trauma-focused treatment for post-traumatic stress disorder due to childhood abuse: Randomised clinical trial. BJPsych Open, 7(6), Article e211. https://doi.org/10.1192/BJO.2021.105
  • Watts, B. V., Schnurr, P. P., Mayo, L., Young-Xu, Y., Weeks, W. B., & Friedman, M. J. (2013). Meta-analysis of the efficacy of treatments for posttraumatic stress disorder. The Journal of clinical psychiatry, 74(6), e541–e550. https://doi.org/10.4088/JCP.12r08225
Fuente de los datos: Dialnet