{"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\/tr\/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":"Birinci basamak sa\u011fl\u0131k hizmetlerinde depresyon tan\u0131s\u0131 konmu\u015f yeti\u015fkinlerde g\u00f6z hareketleriyle duyars\u0131zla\u015ft\u0131rma ve yeniden i\u015fleme terapisi (EMDR) ile ola\u011fan tedavi y\u00f6nteminin etkinli\u011fini ve mekanizmalar\u0131n\u0131 de\u011ferlendiren randomize kontroll\u00fc bir \u00e7al\u0131\u015fma."},"content":{"rendered":"
Mod\u00fcl-1 ba\u015fl\u0131kl\u0131 b\u00f6l\u00fcm<\/span><\/a>
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Birinci basamak sa\u011fl\u0131k hizmetlerinde depresyon tan\u0131s\u0131 konmu\u015f yeti\u015fkinlerde g\u00f6z hareketleriyle duyars\u0131zla\u015ft\u0131rma ve yeniden i\u015fleme terapisi (EMDR) ile ola\u011fan tedavi y\u00f6nteminin etkinli\u011fini ve mekanizmalar\u0131n\u0131 de\u011ferlendiren randomize kontroll\u00fc bir \u00e7al\u0131\u015fma.<\/h1>\n

 <\/p>\n

Finansman<\/h2>\n

Ulusal Sa\u011fl\u0131k ve Bak\u0131m Ara\u015ft\u0131rma Enstit\u00fcs\u00fc (NIHR) Etkinlik ve Mekanizma De\u011ferlendirmesi Referans No: NIHR160513.<\/p>\n

Arka plan<\/h2>\n

Depresyon, birinci basamak sa\u011fl\u0131k hizmetlerinde s\u0131k g\u00f6r\u00fclen bir durum ve i\u015f g\u00f6remezli\u011fin ve i\u015f g\u00fcn\u00fc kay\u0131plar\u0131n\u0131n \u00f6nde gelen nedenlerinden biridir. Hastalar\u0131n sadece yar\u0131s\u0131 en yayg\u0131n tedavilere (antidepresanlar ve bili\u015fsel davran\u0131\u015f\u00e7\u0131 terapi (BDT)) yan\u0131t vermektedir. EMDR, travma sonras\u0131 stres bozuklu\u011fu (TSSB) i\u00e7in NICE taraf\u0131ndan \u00f6nerilen travma odakl\u0131 bir m\u00fcdahaledir. Protokol, depresyon i\u00e7in uyarlanm\u0131\u015ft\u0131r. Stresli ya\u015fam olaylar\u0131ndan (\u00f6rne\u011fin i\u015f kayb\u0131) veya travmatik deneyimlerden (\u00f6rne\u011fin \u00e7ocukluk istismar\u0131) sonra ortaya \u00e7\u0131kabilen ve depresyona yatk\u0131nl\u0131k olu\u015fturabilen ve depresyonu s\u00fcrd\u00fcrebilen i\u015flevsiz bir \u015fekilde depolanm\u0131\u015f an\u0131lar\u0131n yeniden i\u015flenmesinin \u00f6nemini vurgular. EMDR kullanarak depresyonla ba\u011flant\u0131l\u0131 an\u0131lar\u0131 hedeflemek, farkl\u0131 mekanizmalar arac\u0131l\u0131\u011f\u0131yla etki edebilecek yeni bir tedavi yolu sa\u011flar. EMDR'nin depresif semptomlar\u0131 azaltabilece\u011fine dair baz\u0131 kan\u0131tlar vard\u0131r. Bununla birlikte, etkinli\u011fine dair sa\u011flam bir kan\u0131t yoktur ve EMDR'nin nas\u0131l \u00e7al\u0131\u015ft\u0131\u011f\u0131 belirsizdir.<\/p>\n

Ama\u00e7lar ve hedefler<\/h2>\n

Birinci basamak sa\u011fl\u0131k hizmetlerinde depresyonu olan hastalar i\u00e7in EMDR'nin (ola\u011fan pratisyen hekim bak\u0131m\u0131na ek olarak) etkinli\u011fini belirlemek. G\u00f6m\u00fcl\u00fc mekanistik \u00e7al\u0131\u015fma, depresyondaki azalman\u0131n temel bellek i\u015fleme mekanizmalar\u0131 taraf\u0131ndan m\u0131 sa\u011fland\u0131\u011f\u0131n\u0131 ve \u00e7al\u0131\u015fma belle\u011fi kapasitesinin tedavi yan\u0131t\u0131yla ili\u015fkili olup olmad\u0131\u011f\u0131n\u0131 belirleyecektir. \u0130\u00e7 i\u00e7e ge\u00e7mi\u015f nitel bir \u00e7al\u0131\u015fma, EMDR'nin depresyon i\u00e7in kabul edilebilirli\u011fini inceleyecek, mekanizmalar\u0131 daha ayr\u0131nt\u0131l\u0131 olarak ara\u015ft\u0131racak ve farkl\u0131 yan\u0131tlar\u0131n olas\u0131 nedenlerini belirleyecektir. Bir m\u00fcdahale maliyetlendirme \u00e7al\u0131\u015fmas\u0131, NHS'de EMDR uygulamas\u0131n\u0131n maliyetini tahmin edecektir.<\/p>\n

Y\u00f6ntemler<\/h2>\n

Birinci basamak sa\u011fl\u0131k hizmetlerinde bireysel d\u00fczeyde tahsisatla, iki paralel gruplu, \u00e7ok merkezli, bireysel olarak randomize edilmi\u015f kontroll\u00fc bir \u00e7al\u0131\u015fma. Uygun hastalar 18 ya\u015f ve \u00fczeri, Beck Depresyon Envanteri (BDI-II) puan\u0131 \u226514 olan ve ICD-11 depresyon kriterlerini kar\u015f\u0131layan ki\u015filerdir. Kat\u0131l\u0131mc\u0131lar, rutin bak\u0131ma ek olarak m\u00fcdahale grubuna (12-18 seans EMDR: haftal\u0131k 60-90 dakika bireysel y\u00fcz y\u00fcze) veya rutin bak\u0131ma devam etme grubuna randomize edilecektir. Birincil (etkinlik) sonu\u00e7, 26. haftadaki BDI-II puan\u0131 olacakt\u0131r. \u0130kincil sonu\u00e7lar aras\u0131nda remisyon (BDI-II puan\u0131 <10), anksiyete, fonksiyon, ya\u015fam kalitesi ve 52. haftadaki sonu\u00e7lar yer alacakt\u0131r. Arac\u0131 de\u011fi\u015fkenler, tedavi s\u0131ras\u0131nda 16. haftada \u00f6l\u00e7\u00fclecektir. 380 kat\u0131l\u0131mc\u0131l\u0131k bir \u00f6rneklem b\u00fcy\u00fckl\u00fc\u011f\u00fc, 26. haftadaki 'lik kay\u0131p pay\u0131 dikkate al\u0131narak, 0,378'lik bir etki b\u00fcy\u00fckl\u00fc\u011f\u00fcn\u00fc tespit etmek i\u00e7in iki tarafl\u0131 'lik anlaml\u0131l\u0131k d\u00fczeyinde 'l\u0131k bir g\u00fc\u00e7 sa\u011flayacakt\u0131r. Bu \u00f6rneklem b\u00fcy\u00fckl\u00fc\u011f\u00fcyle, 40%, 30% ve 20%'lik dolayl\u0131 bir etkiyi tespit etmek i\u00e7in s\u0131ras\u0131yla 87,2%, 87% ve 79,4% g\u00fcce sahip olaca\u011f\u0131z. Kat\u0131l\u0131mc\u0131larla g\u00f6r\u00fc\u015fmeler, birincil (etkinlik) sonu\u00e7lar\u0131n\u0131n (20 m\u00fcdahale, 10 kontrol grubu) tamamlanmas\u0131n\u0131n ard\u0131ndan ve t\u00fcm deneme terapistleri ve s\u00fcperviz\u00f6rleriyle ger\u00e7ekle\u015ftirilecektir. G\u00f6r\u00fc\u015fmeler ses kayd\u0131 alt\u0131na al\u0131nacak, kelimesi kelimesine yaz\u0131ya d\u00f6k\u00fclecek ve tematik olarak analiz edilecektir. EMDR uygulamas\u0131 ve s\u00fcpervizyonu ile ilgili veriler toplanacak ve ilgili maliyetler, birim maliyetler i\u00e7in ulusal olarak mevcut kaynaklar kullan\u0131larak tahmin edilecektir.<\/p>\n

Teslimat s\u00fcreleri<\/h2>\n

Ba\u015flang\u0131\u00e7: Mart 2025. Kurulum, onaylar ve terapist e\u011fitimi: 8 ay. 6 ayl\u0131k dahili pilot uygulama. 'Ba\u015far\u0131' kriterleri kar\u015f\u0131lan\u0131rsa, Ekim 2027'ye kadar kat\u0131l\u0131mc\u0131 al\u0131m\u0131 ve Ekim 2028'e kadar takip \u00e7al\u0131\u015fmas\u0131. Veri analizi ve rapor yaz\u0131m\u0131 i\u00e7in 6 ay. Nihai rapor: Nisan 2029.<\/p>\n

Beklenen etki ve yay\u0131l\u0131m<\/h2>\n

\u00c7al\u0131\u015fmalar\u0131m\u0131zda yer alan payda\u015flar ve hasta-hasta kat\u0131l\u0131m\u0131 temsilcileriyle birlikte, sonu\u00e7lar\u0131n geni\u015f \u00e7apta yayg\u0131nla\u015ft\u0131r\u0131lmas\u0131n\u0131 sa\u011flayacak bir plan geli\u015ftirece\u011fiz. Sonu\u00e7lar, NICE k\u0131lavuzlar\u0131n\u0131 ve NHS'deki konu\u015fma terapisi hizmetlerinde akredite EMDR terapistlerinin say\u0131s\u0131n\u0131 art\u0131rmaya y\u00f6nelik planlar\u0131 etkileyecektir.<\/p>\n

Ara\u015ft\u0131rmay\u0131 kim y\u00fcr\u00fct\u00fcyor?<\/h2>\n

Profes\u00f6r Nicola Wiles, Epidemiyoloji Profes\u00f6r\u00fc, Bristol T\u0131p Fak\u00fcltesi (PHS), Bristol \u00dcniversitesi.<\/p>\n

Daha fazla bilgi<\/h2>\n

CI E-postas\u0131: Nicola.Wiles@bristol.ac.uk<\/p>\n

Daha fazla bilgi almak veya bu projeye kat\u0131lmak i\u00e7in l\u00fctfen ileti\u015fime ge\u00e7in.\u00a0bnssg.research@nhs.net<\/a>.<\/p>\n

Burada ifade edilen g\u00f6r\u00fc\u015fler yazar(lar)a aittir ve NIHR veya Sa\u011fl\u0131k ve Sosyal Bak\u0131m Bakanl\u0131\u011f\u0131'n\u0131n g\u00f6r\u00fc\u015flerini yans\u0131tmayabilir.<\/p>\n

Daha fazla bilgi i\u00e7in l\u00fctfen inceleyin. Burada<\/a>.<\/p>\n <\/div>\r\n <\/section><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"

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\/tr\/wp-json\/wp\/v2\/pages\/43244","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bnssghealthiertogether.org.uk\/tr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/bnssghealthiertogether.org.uk\/tr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/bnssghealthiertogether.org.uk\/tr\/wp-json\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/bnssghealthiertogether.org.uk\/tr\/wp-json\/wp\/v2\/comments?post=43244"}],"version-history":[{"count":2,"href":"https:\/\/bnssghealthiertogether.org.uk\/tr\/wp-json\/wp\/v2\/pages\/43244\/revisions"}],"predecessor-version":[{"id":43246,"href":"https:\/\/bnssghealthiertogether.org.uk\/tr\/wp-json\/wp\/v2\/pages\/43244\/revisions\/43246"}],"up":[{"embeddable":true,"href":"https:\/\/bnssghealthiertogether.org.uk\/tr\/wp-json\/wp\/v2\/pages\/32881"}],"wp:attachment":[{"href":"https:\/\/bnssghealthiertogether.org.uk\/tr\/wp-json\/wp\/v2\/media?parent=43244"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bnssghealthiertogether.org.uk\/tr\/wp-json\/wp\/v2\/tags?post=43244"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}