Cited by 19Posttraumatic Stress Disorder ResearchCOVID-19 and Mental HealthIntensive Care Unit Cognitive Disorders

A randomised pilot feasibility study of eye movement desensitisation and reprocessing recent traumatic episode protocol, to improve psychological recovery following intensive care admission for COVID-19

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Bates, Andrew, Golding, Hannah, Rushbrook, Sophie, Shapiro, Elan, Pattison, Natalie, Baldwin, David S, Grocott, Michael P W, Cusack, Rebecca·2023·Journal of the Intensive Care Society

Abstract

Background: Approximately 50% of intensive care survivors experience persistent psychological symptoms. Eye-movement desensitisation and reprocessing (EMDR) is a widely recommended trauma-focussed psychological therapy, which has not been investigated systematically in a cohort of intensive care survivors: We therefore conducted a randomised pilot feasibility study of EMDR, using the Recent Traumatic Episode Protocol (R-TEP), to prevent psychological distress in intensive care survivors. Findings will determine whether it would be possible to conduct a fully-powered clinical effectiveness trial and inform trial design. Method: We aimed to recruit 26 patients who had been admitted to intensive care for over 24 h with COVID-19 infection. Consenting participants were randomised (1:1) to receive either usual care plus remotely delivered EMDR R-TEP or usual care alone (controls). The primary outcome was feasibility. We also report factors related to safety and symptom changes in post-traumatic stress disorder, (PTSD) anxiety and depression. Results: We approached 51 eligible patients, with 26 (51%) providing consent. Intervention adherence (sessions offered/sessions completed) was 83%, and 23/26 participants completed all study procedures. There were no attributable adverse events. Between baseline and 6-month follow-up, mean change in PTSD score was −8 (SD = 10.5) in the intervention group versus +0.75 (SD = 15.2) in controls ( p = 0.126). There were no significant changes to anxiety or depression. Conclusion: Remotely delivered EMDR R-TEP met pre-determined feasibility and safety objectives. Whilst we achieved group separation in PTSD symptom change, we have identified a number of protocol refinements that would improve the design of a fully powered, multi-centre randomised controlled trial, consistent with currently recommended rehabilitation clinical pathways. Trial registration: ClinicalTrials.gov: NCT04455360.

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  1. Novo Navarro P, Landin-Romero R, Guardiola-Wanden-Berghe R, et al. 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. Rev
  2. Hulme T. Using eye movement therapy to reduce trauma after intensive care. Nursing Times. 2018;114(3):18-21.
  3. Wake S, Kitchiner D. Post-traumatic stress disorder after intensive care. BMJ. 2013 May 22;346:f3232.
  4. Shapiro, E., Laub, B., & Rosenblat O. Early EMDR intervention following intense rocket attacks on a town: A randomised clinical trial. Clin Neuropsychiatry J Treat Eval. 2018;15(3):194-205.
  5. Mohd Razali N, Bee Wah Y. Power comparisons of Shapiro-Wilk, Kolmogorov-Smirnov, Lilliefors and Anderson-Darling tests. Vol. 2, Journal of Statistical Modeling and Analytics. 2011. 21-33 p.
  6. Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ. 2014 Mar 7;348:g1687. References:
  7. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med. 1985 Oct;13(10):818-29.
  8. Wade DM, Howell DC, Weinman JA, Hardy RJ, Mythen MG, Brewin CR, et al. Investigating risk factors for psychological morbidity three months after intensive care: a prospective cohort study. Crit Care. 2012 Oct 15;16(5):R192.
  9. Karstoft KI, Andersen SB, Bertelsen M, Madsen T. Diagnostic accuracy of the Posttraumatic Stress Disorder Checklist-Civilian Version in a representative military sample. Psychol Assess. 2013 Mar;26(1):321.
  10. Hatch R, Young D, Barber V, Griffiths J, Harrison DA, Watkinson P. Anxiety, Depression and Post Traumatic Stress Disorder after critical illness: a UK-wide prospective cohort study. Crit Care. 2018;22(1):310.
  11. Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand. 1983, Jun;67(6):361-70.
  12. Jutte JE, Needham DM, Pfoh ER, Bienvenu OJ. Psychometric evaluation of the Hospital Anxiety and Depression Scale 3 months after acute lung injury. J Crit Care. 2015 Aug;30(4):793-8.
  13. Herdman M, Gudex • C, Lloyd • A, Janssen MF, Kind • P, Parkin • D, et al. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res. 2011 Dec;20(10):1727-36
  14. Smith BW, Dalen J, Wiggins K, Tooley E, Christopher P, Bernard J. The brief resilience scale: Assessing the ability to bounce back. Int J Behav Med. 2008 Sep;15(3):194-200.
  15. Wilson M-MG, Thomas DR, Rubenstein LZ, Chibnall JT, Anderson S, Baxi A, et al. Appetite assessment: simple appetite questionnaire predicts weight loss in community-dwelling adults and nursing home residents. Am J Clin Nutr. 2005 Nov 1;82(5):1074-81.
  16. Losonczy KG, Harris TB, Cornoni-Huntley J, Simonsick EM, Wallace RB, Cook NR, et al. Does weight loss from middle age to old age explain the inverse weight mortality relation in old age? Am J Epidemiol. 1995 Feb 15;141(4):312-21.

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Authors
Bates, A., Golding, H., Rushbrook, S., Shapiro, E., Pattison, N., Baldwin, D. S., Grocott, M. P. W., & Cusack, R.
Affiliations
  • National Health Service (GB)
  • Dorset HealthCare University NHS Foundation Trust (GB)
  • Independent EMDR Europe Consultant Practitioner, Haifa, Israel
  • University of Hertfordshire (GB)
  • Southern Health NHS Foundation Trust (GB)
Corresponding author
Bates, Andrew
Venue
Journal of the Intensive Care Society
Published
2022-11-19
Volume
24
Issue
3
Pages
309-319
ISSN
1751-1437 (ISSN-L)
OpenAlex
W4309561523
Cited by
19
References
65
Citations by year
2026: 6 · 2025: 3 · 2024: 8 · 2023: 2
FWCI
2.97
Type
journal article
Language
en
Open access
Locations
  • Journal of the Intensive Care Society (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • ePrints Soton (University of Southampton) (acceptedVersion)
  • University of Hertfordshire Research Archive (University of Hertfordshire) (acceptedVersion)
  • University of Hertfordshire Research Archive (University of Hertfordshire) (submittedVersion)
Funders
Research Trainees Coordinating Centre (19792)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
Keywords
EMDR, intensive care unit survivors, COVID-19 pandemic, post-traumatic stress disorder, psychological recovery, remote psychological intervention, trauma-focused psychotherapy, anxiety, depression, feasibility

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