{"id":43244,"date":"2025-10-08T15:21:15","date_gmt":"2025-10-08T14:21:15","guid":{"rendered":"https:\/\/bnssghealthiertogether.org.uk\/?page_id=43244"},"modified":"2025-10-08T15:21:15","modified_gmt":"2025-10-08T14:21:15","slug":"a-randomised-controlled-trial-evaluating-the-efficacy-and-mechanisms-of-eye-movement-desensitisation-and-reprocessing-therapy-emdr-compared-with-treatment-as-usual-for-adults-with-depression-in-prim","status":"publish","type":"page","link":"https:\/\/bnssghealthiertogether.org.uk\/ro\/integrated-care-board\/research-and-evidence\/our-research-portfolio\/nihr-funded-projects\/a-randomised-controlled-trial-evaluating-the-efficacy-and-mechanisms-of-eye-movement-desensitisation-and-reprocessing-therapy-emdr-compared-with-treatment-as-usual-for-adults-with-depression-in-prim\/","title":{"rendered":"Un studiu clinic randomizat controlat care evalueaz\u0103 eficacitatea \u0219i mecanismele terapiei de desensibilizare \u0219i reprocesare prin mi\u0219c\u0103ri oculare (EMDR) comparativ cu tratamentul obi\u0219nuit pentru adul\u021bii cu depresie \u00een asisten\u021ba medical\u0103 primar\u0103"},"content":{"rendered":"<div class=\"assembler_default-group assembler_module_group assembler_default-group_1 assembler_module_group_1\"><div class=\"assembler_module_area assembler_module_area_1\"><div class=\"assembler_text-module assembler_module assembler_text-module_1 assembler_module_1  transparent\"><a tabindex=\"-1\" title=\"Sec\u021biunea intitulat\u0103 modul-1\" id=\"module-1\" href=\"https:\/\/bnssghealthiertogether.org.uk\/ro\/wp-json\/wp\/v2\/pages\/43244\/#module-1\" class=\"anchor\"><span class=\"hidden\">Sec\u021biunea intitulat\u0103 modul-1<\/span><\/a><!-- Template found for text-module - Template: template-text - Matched: _only --><section class=\"w-full mx-auto max-w-content pt-12 sm:pt-24 pb-12 sm:pb-24\">\r\n  <div class=\"entry-content w-full !px-0 max-w-small\">\r\n        <h1>Un studiu clinic randomizat controlat care evalueaz\u0103 eficacitatea \u0219i mecanismele terapiei de desensibilizare \u0219i reprocesare prin mi\u0219c\u0103ri oculare (EMDR) comparativ cu tratamentul obi\u0219nuit pentru adul\u021bii cu depresie \u00een asisten\u021ba medical\u0103 primar\u0103<\/h1>\n<p>&nbsp;<\/p>\n<h2>Finan\u021bare<\/h2>\n<p>Institutul Na\u021bional pentru Cercetare \u00een Domeniul S\u0103n\u0103t\u0103\u021bii \u0219i \u00cengrijirii (NIHR) Evaluarea Eficacit\u0103\u021bii \u0219i Mecanismului Ref NIHR160513.<\/p>\n<h2>Fundal<\/h2>\n<p>Depresia este o afec\u021biune frecvent\u0103 \u00een asisten\u021ba medical\u0103 primar\u0103 \u0219i o cauz\u0103 principal\u0103 de dizabilitate \u0219i zile de munc\u0103 pierdute. Doar jum\u0103tate dintre pacien\u021bi r\u0103spund la cele mai frecvente tratamente (antidepresive \u0219i terapie cognitiv-comportamental\u0103 (TCC)). EMDR este o interven\u021bie axat\u0103 pe traum\u0103, recomandat\u0103 de NICE, pentru tulburarea de stres posttraumatic (PTSD). Protocolul a fost adaptat pentru depresie. Acesta subliniaz\u0103 importan\u021ba reproces\u0103rii amintirilor stocate disfunc\u021bional, care pot ap\u0103rea dup\u0103 evenimente stresante din via\u021b\u0103 (de exemplu, pierderea locului de munc\u0103) sau experien\u021be traumatice (de exemplu, abuz \u00een copil\u0103rie) \u0219i care pot predispune la depresie \u0219i pot men\u021bine depresia. Vizarea amintirilor legate de depresie folosind EMDR ofer\u0103 o nou\u0103 cale de tratament care poate ac\u021biona prin mecanisme diferite. Exist\u0103 unele dovezi c\u0103 EMDR poate reduce simptomele depresive. Cu toate acestea, nu exist\u0103 dovezi solide de eficacitate \u0219i nu este clar cum func\u021bioneaz\u0103 EMDR.<\/p>\n<h2>Scopuri \u0219i obiective<\/h2>\n<p>Pentru a stabili eficacitatea EMDR (\u00een plus fa\u021b\u0103 de \u00eengrijirea medical\u0103 obi\u0219nuit\u0103 de familie (CU)) \u00een compara\u021bie cu CU la pacien\u021bii cu depresie \u00een asisten\u021ba medical\u0103 primar\u0103. Studiul mecanistic integrat va determina dac\u0103 reducerile depresiei sunt mediate de mecanisme cheie de procesare a memoriei \u0219i dac\u0103 capacitatea memoriei de lucru este asociat\u0103 cu r\u0103spunsul la tratament. Un studiu calitativ imbricat va examina acceptabilitatea EMDR pentru depresie, va explora \u00een continuare mecanismele \u0219i va identifica posibilele cauze ale r\u0103spunsurilor diferite. Un exerci\u021biu de calculare a costurilor interven\u021biei va estima costul furniz\u0103rii EMDR \u00een cadrul NHS.<\/p>\n<h2>Metode<\/h2>\n<p>Dou\u0103 studii clinice controlate, randomizate individual, multicentrice, cu grupuri paralele, cu alocare la nivelul setului individual din asisten\u021ba medical\u0103 primar\u0103. Pacien\u021bi eligibili cu v\u00e2rsta = 18 ani, au un scor Beck pentru depresie (BDI-II) = 14 \u0219i \u00eendeplinesc criteriile ICD-11 pentru depresie. Participan\u021bii vor fi randomiza\u021bi pentru interven\u021bie (12-18 sesiuni de EMDR: s\u0103pt\u0103m\u00e2nal 60-90 de minute individual, fa\u021b\u0103 \u00een fa\u021b\u0103) pe l\u00e2ng\u0103 CU sau pentru a continua cu CU. Rezultatul principal (eficacitate) va fi scorul BDI-II la 26 de s\u0103pt\u0103m\u00e2ni. Rezultatele secundare vor include remisia (scor BDI-II &lt;10), anxietatea, func\u021bia, calitatea vie\u021bii \u0219i rezultatele la 52 de s\u0103pt\u0103m\u00e2ni. Mediatorii vor fi m\u0103sura\u021bi \u00een timpul tratamentului, la 16 s\u0103pt\u0103m\u00e2ni. Un e\u0219antion de 380 de participan\u021bi va oferi o putere 90% la un nivel de semnifica\u021bie 5% bilateral pentru a detecta o dimensiune a efectului de 0,378, permi\u021b\u00e2nd o abandonare a 25% la 26 de s\u0103pt\u0103m\u00e2ni. Cu aceast\u0103 dimensiune a e\u0219antionului, vom avea o putere statistic\u0103 de 87,2%, 87% \u0219i 79,4% pentru a detecta un efect indirect al 40%, 30% \u0219i 20%. Interviurile cu participan\u021bii vor avea loc dup\u0103 finalizarea rezultatelor lor primare (de eficacitate) (20 de interven\u021bii, 10 de reumatoide) \u0219i cu to\u021bi terapeu\u021bii \u0219i supervizorii studiului clinic. Interviurile vor fi \u00eenregistrate audio, transcrise ad litteram \u0219i analizate tematic. Datele privind furnizarea \u0219i supervizarea EMDR vor fi colectate, iar costurile asociate vor fi estimate utiliz\u00e2nd surse disponibile la nivel na\u021bional pentru costurile unitare.<\/p>\n<h2>Termene de livrare<\/h2>\n<p>\u00cenceput: martie 2025. Configurare, aprob\u0103ri \u0219i instruire terapeu\u021bi: 8 luni. Pilot intern de 6 luni. Dac\u0103 sunt \u00eendeplinite criteriile de \u2018integrare\u2019, recrutarea se va face p\u00e2n\u0103 \u00een octombrie 2027 \u0219i urm\u0103rirea se va face p\u00e2n\u0103 \u00een octombrie 2028. 6 luni pentru analiza datelor \u0219i redactarea raportului. Raport final: aprilie 2029.<\/p>\n<h2>Impactul \u0219i diseminarea anticipate<\/h2>\n<p>Vom dezvolta un plan \u00eempreun\u0103 cu colaboratorii no\u0219tri, p\u0103r\u021bile interesate \u0219i reprezentan\u021bii PPI pentru a ne asigura c\u0103 rezultatele sunt diseminate pe scar\u0103 larg\u0103. Rezultatele vor influen\u021ba ghidurile NICE \u0219i planurile de cre\u0219tere a num\u0103rului de terapeu\u021bi EMDR acredita\u021bi \u00een serviciile de terapie prin vorbire ale NHS.<\/p>\n<h2>Cine conduce cercetarea?<\/h2>\n<p>Profesor Nicola Wiles, profesor de epidemiologie, Facultatea de Medicin\u0103 din Bristol (PHS), Universitatea din Bristol.<\/p>\n<h2>Informa\u021bii suplimentare<\/h2>\n<p>CI Email: Nicola.Wiles@bristol.ac.uk<\/p>\n<p>Pentru mai multe informa\u021bii sau pentru a v\u0103 implica \u00een acest proiect, v\u0103 rug\u0103m s\u0103 contacta\u021bi\u00a0<a href=\"mailto:bnssg.research@nhs.net\">bnssg.research@nhs.net<\/a>.<\/p>\n<p>Opiniile exprimate sunt cele ale autorului\/autorilor \u0219i nu neap\u0103rat cele ale NIHR sau ale Departamentului de S\u0103n\u0103tate \u0219i Asisten\u021b\u0103 Social\u0103.<\/p>\n<p>V\u0103 rug\u0103m s\u0103 g\u0103si\u021bi mai multe informa\u021bii <a href=\"https:\/\/fundingawards.nihr.ac.uk\/award\/NIHR160513\" rel=\"noopener\">aici<\/a>.<\/p>\n  <\/div>\r\n  <\/section><\/div><!-- .assembler_text-module.assembler_module.assembler_text-module_1.assembler_module_1..transparent --><\/div><!-- .assembler_module_area.assembler_module_area_1 --><\/div><!-- .assembler_default-group.assembler_module_group.assembler_default-group_1.assembler_module_group_1  -->","protected":false},"excerpt":{"rendered":"<p>The embedded mechanistic study will determine whether reductions in depression are mediated by key memory-processing mechanisms and if working memory capacity is associated with treatment response. <\/p>","protected":false},"author":16,"featured_media":0,"parent":32881,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"tags":[],"class_list":["post-43244","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/bnssghealthiertogether.org.uk\/ro\/wp-json\/wp\/v2\/pages\/43244","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bnssghealthiertogether.org.uk\/ro\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/bnssghealthiertogether.org.uk\/ro\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/bnssghealthiertogether.org.uk\/ro\/wp-json\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/bnssghealthiertogether.org.uk\/ro\/wp-json\/wp\/v2\/comments?post=43244"}],"version-history":[{"count":2,"href":"https:\/\/bnssghealthiertogether.org.uk\/ro\/wp-json\/wp\/v2\/pages\/43244\/revisions"}],"predecessor-version":[{"id":43246,"href":"https:\/\/bnssghealthiertogether.org.uk\/ro\/wp-json\/wp\/v2\/pages\/43244\/revisions\/43246"}],"up":[{"embeddable":true,"href":"https:\/\/bnssghealthiertogether.org.uk\/ro\/wp-json\/wp\/v2\/pages\/32881"}],"wp:attachment":[{"href":"https:\/\/bnssghealthiertogether.org.uk\/ro\/wp-json\/wp\/v2\/media?parent=43244"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bnssghealthiertogether.org.uk\/ro\/wp-json\/wp\/v2\/tags?post=43244"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}