Eye movement desensitization and reprocessing (EMDR) therapy or supportive counseling prior to exposure therapy in patients with panic disorder: study protocol for a multicenter randomized controlled trial (IMPROVE).

Autor: Endhoven B; Department of Clinical Psychology, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands. b.endhoven@uu.nl.; Altrecht Academic Anxiety Center, Nieuwe, Houtenseweg 12, 3524 SH, Utrecht, The Netherlands. b.endhoven@uu.nl., De Cort K; Academic Anxiety Center, Mondriaan/PsyQ, Oranjeplein 10, 6624 KD, Maastricht, The Netherlands.; Department of Psychiatry and Neuropsychology, Maastricht University, PO Box 616, 6200MD, Maastricht, The Netherlands., Matthijssen SJMA; Department of Clinical Psychology, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands.; Altrecht Academic Anxiety Center, Nieuwe, Houtenseweg 12, 3524 SH, Utrecht, The Netherlands., de Jongh A; PSYTREC, Professor Bronkhorstlaan 2, 3723 MB, Bilthoven, The Netherlands.; Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam), Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands., van Minnen A; PSYTREC, Professor Bronkhorstlaan 2, 3723 MB, Bilthoven, The Netherlands.; Behavioural Science Institute, Radboud University, PO Box 9104, 6500HE, Nijmegen, The Netherlands., Duits P; Altrecht Academic Anxiety Center, Nieuwe, Houtenseweg 12, 3524 SH, Utrecht, The Netherlands., Schruers KRJ; Academic Anxiety Center, Mondriaan/PsyQ, Oranjeplein 10, 6624 KD, Maastricht, The Netherlands.; Department of Psychiatry and Neuropsychology, Maastricht University, PO Box 616, 6200MD, Maastricht, The Netherlands.; Research Group Health Psychology, PO Box 3726, 3000, Leuven, KU, Belgium., van Dis EAM; Department of Clinical Psychology, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands., Krypotos AM; Department of Clinical Psychology, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands.; Research Group Health Psychology, PO Box 3726, 3000, Leuven, KU, Belgium., Gerritsen L; Department of Clinical Psychology, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands., Engelhard IM; Department of Clinical Psychology, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands.; Altrecht Academic Anxiety Center, Nieuwe, Houtenseweg 12, 3524 SH, Utrecht, The Netherlands.
Jazyk: angličtina
Zdroj: BMC psychiatry [BMC Psychiatry] 2023 Mar 14; Vol. 23 (1), pp. 157. Date of Electronic Publication: 2023 Mar 14.
DOI: 10.1186/s12888-022-04320-4
Abstrakt: Background: Exposure-based therapy is the treatment of choice for anxiety disorders, but many patients do not benefit sufficiently from it. Distressing images of threat related to the future or past may maintain the anxiety symptomatology or impede exposure therapy. An intervention that targets threat-related imagery is eye movement desensitization and reprocessing (EMDR) therapy. The main goal of this multicenter randomized controlled trial is to investigate whether EMDR therapy plus exposure therapy, relative to supportive counseling plus exposure therapy, improves treatment efficacy, tolerability, and adherence in patients with panic disorder. In addition, we will examine potential predictors of optimal treatment allocation, mechanisms of change as well as the long term effects of treatment. Finally, we will assess cost-effectiveness.
Methods: A multicenter randomized controlled trial mixed design will be conducted. Participants will be 50 patients, aged ≥ 18, diagnosed with a panic disorder. They will be randomly assigned to one of two conditions: EMDR therapy (i.e., flashforward strategy) or supportive counseling (each consisting of four weekly sessions of 90 min each) prior to exposure therapy (consisting of eight weekly sessions of 90 min each). Assessments will be made pre-treatment (T1), between-treatments (T2), post-treatment (T3), one month post-treatment (FU1) and six months post-treatment (FU2) by an assessor blind to treatment condition. The primary outcome measure is severity of panic-related symptoms. Secondary outcome measures are: tolerability of exposure therapy (initial avoidance, willingness to start exposure therapy, considered drop-out; no-show and drop-out), related symptomatology (generalized anxiety, depression), and functional impairment.
Discussion: The primary goals of this research are to compare the efficacy, tolerability, and adherence of EMDR therapy plus exposure therapy and supportive counseling plus exposure therapy and to identify predictors, moderators, and mediators for treatment success. This multi-center research aims to make a significant contribution to our understanding as to how treatment for patients with anxiety disorders can be optimized, and elucidate who can benefit most from this novel approach.
Trial Registration: ISRCTN-ISRCTN29668369: Improving anxiety treatment by modifying emotional memories before real-life exposure. Registered 27 June 2022-retrospectively registered. ISRCTN-ISRCTN29668369.
(© 2023. The Author(s).)
Databáze: MEDLINE
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