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Eye Movement Desensitization and Reprocessing on Autoimmune Thyroiditis in Adults

Primary Purpose

Hashimoto

Status
Completed
Phase
Not Applicable
Locations
Romania
Study Type
Interventional
Intervention
Eye Movement Desensitization and Reprocessing
Placebo
Treatment as Usual
Sponsored by
University of Bucharest
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Hashimoto focused on measuring Hashimoto, Autoimmune thyroiditis, Eye Movement Desensitization adn Reprocessing, Trauma

Eligibility Criteria

18 Years - 55 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • aged 18-55 years;
  • confirmed autoimmune thyroiditis diagnosis
  • at least one biological marker Anti-thyroid peroxidase (anti-TPO) antibodies or thyroglobulin antibodies (TgAb) exceeds the reference range

Exclusion Criteria:

  • the presence of psychotic symptoms
  • currently receiving another form of psychological treatment;
  • under psychotropic medication;
  • neurodevelopmental disorders (intellectual disability, communication disorders, autism spectrum disorders, ADHD);
  • neurocognitive disorders;
  • substance abuse;
  • serious legal or health issues that would prevent from regularly attending
  • patients with autoimmune thyroiditis with biological markers within the reference range

Sites / Locations

  • University of Bucharest

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Placebo Comparator

Active Comparator

Arm Label

Eye Movement Desensitization and Reprocessing

Placebo

Treatment as Usual

Arm Description

30 participants will be randomly allocated to the EMDR group. They will receive a 90 minutes session of EMDR each week for twelve weeks. The sessions will be conducted by clinicians or psychotherapists specialized in EMDR, and the participants will be randomly allocated to them. EMDR is a structured, goal-oriented, short-term intervention organized around traumatic or stressful memories. This method was discovered in 1981 by F. Shapiro and represented an evidence-based treatment, one of the two first-line trauma treatment recommended for use with adults (NICE, 2005; World Health Organization, 2013). EMDR proved effective by hundreds of researches and has also been shown to be useful in alleviating physical symptoms such as pain or increased autonomic activity. But to our knowledge, research on EMDR efficacy in the treatment of autoimmune thyroiditis has not been previously reported.

30 participants will be randomized to the placebo group. The placebo goup will receive an intervention that does not include working on past traumatic memories, it will be more focused on present and future.

30 participants will be randomized to this group. They will continue only the medical treatment for Hashimoto their doctor prescribed to them.

Outcomes

Primary Outcome Measures

Measurement of anti-thyroid peroxidase levels (anti-TPO)
Measurement of anti-thyroid peroxidase in adults with Hashimoto at baseline, post-treatment and follow-up, after trauma therapy with EMDR
Measurement of thyroglobulin levels (TgAb)
Measurement of thyroglobulin antibodies levels in adults with Hashimoto at baseline, post-treatment and follow-up, after trauma therapy with EMDR

Secondary Outcome Measures

State-Trait Anger Expression Inventory
Perceptions about anger expression in adults with Hashimoto will be measured at baseline, post-treatment and follow-up, after EMDR treatment. The inventory assesses a various area of anger and the traits of experiencing anger. Participants are asked to respond to 44 items using a 4-point scale ("Not at all" to "Almost always").
Toronto Alexithymia Scale
Perceptions about alexithymia will be measured at baseline, post-treatment and follow-up, after EMDR treatment. Toronto Alexithymia Scale is a 20 item self-report instrument, with each item rated on a 5-point Likert scale ranging from 1 (Strongly Disagree) to 5 (Strongly Agree).
Dissociative Experiences Scale
Perceptions about the levels of dissociation will be measured at baseline, post-treatment and follow-up, after EMDR treatment. The instrument is a self-assessment questionnaire used to screen for dissociative symptoms. It consists of 28 items that assess the frequency and severity of a wide range of dissociative experiences using an eleven-point visual analog scale (0%-100%).
The Depression Anxiety Stress Scales
Perceptions about depression, anxiety and stress levels will be measured at baseline, post-treatment and follow-up, after EMDR treatment. The instrument is a set of three self-report scales designed to measure the emotional states of depression, anxiety, and stress. Each of the three scales contains seven items.
The World Health Organization Quality of Life
Perceptions about the quality of life will be measured at baseline, post-treatment and follow-up, after EMDR treatment. The instrument is a 26-item self-report tapping into the following broad domains: physical health, psychological health, social relationships, and environment.

Full Information

First Posted
July 7, 2020
Last Updated
April 22, 2021
Sponsor
University of Bucharest
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1. Study Identification

Unique Protocol Identification Number
NCT04472988
Brief Title
Eye Movement Desensitization and Reprocessing on Autoimmune Thyroiditis in Adults
Official Title
The Effects of Eye Movement Desensitization and Reprocessing on Autoimmune Thyroiditis in Adults: a Randomized Controlled Trial
Study Type
Interventional

2. Study Status

Record Verification Date
April 2021
Overall Recruitment Status
Completed
Study Start Date
January 1, 2020 (Actual)
Primary Completion Date
December 5, 2020 (Actual)
Study Completion Date
March 23, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Bucharest

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to evaluate whether Eye Movement Desensitization and Reprocessing (EMDR) is effective in decreasing the level of autoantibodies of patients with autoimmune thyroiditis. The investigators hypothesize that processing traumatic memories from events that happened before the illness onset will have a positive impact first on the psyche (a) by decreasing the level of dissociation, alexithymia, anger, and (b) by increasing the quality of life and emotional regulation, than those in the control group. Secondly, it will have an impact on the biological level, by decreasing the level of autoantibodies, antithyroglobulin antibody (anti-Tg) and anti-thyroid peroxidase antibody (anti-TPO), which are the main antibodies detected in chronic autoimmune thyroiditis.
Detailed Description
Hashimoto thyroiditis is an autoimmune disease that leads to chronic inflammation of the thyroid gland. This is considered the most common autoimmune disorder, and the most common endocrine disorder. Psychological trauma has been suggested as a possible factor in the pathogenesis and development of autoimmune diseases. Although a diversity of psychotherapeutic interventions have been studied in adults with autoimmune diseases, there is a lack of psychological research and randomized controlled trials in the field of the Hashimoto disease. This study is designed to be a clinical trial with three arms: one experimental and two control groups. The experimental group receives EMDR, one control group receive placebo and the other is a waiting list. 90 out-patients with Hashimoto disease will be randomly assigned to the three groups. The investigators hypothesize that the therapeutic gains will be more significant in the experimental condition than in the control groups at the completion of the therapy and that this will be maintained at the 3-month follow-up.The EMDR group undergoes a 90 minutes session of EMDR each week for twelve weeks.The sessions will be conducted by clinicians or psychotherapists specialized in EMDR. The placebo group will receive a similar amount of time of placebo intervention. If therapy is efficient on the autoimmune disorder, participants in the control groups will be reallocated to EMDR after the experimental treatment will come to an end.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hashimoto
Keywords
Hashimoto, Autoimmune thyroiditis, Eye Movement Desensitization adn Reprocessing, Trauma

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Masking Description
During the study an endocrinologist who will be blinded to randomization groups will evaluate the biological markers of the participants at baseline, post-treatment and follow-up.
Allocation
Randomized
Enrollment
91 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Eye Movement Desensitization and Reprocessing
Arm Type
Experimental
Arm Description
30 participants will be randomly allocated to the EMDR group. They will receive a 90 minutes session of EMDR each week for twelve weeks. The sessions will be conducted by clinicians or psychotherapists specialized in EMDR, and the participants will be randomly allocated to them. EMDR is a structured, goal-oriented, short-term intervention organized around traumatic or stressful memories. This method was discovered in 1981 by F. Shapiro and represented an evidence-based treatment, one of the two first-line trauma treatment recommended for use with adults (NICE, 2005; World Health Organization, 2013). EMDR proved effective by hundreds of researches and has also been shown to be useful in alleviating physical symptoms such as pain or increased autonomic activity. But to our knowledge, research on EMDR efficacy in the treatment of autoimmune thyroiditis has not been previously reported.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
30 participants will be randomized to the placebo group. The placebo goup will receive an intervention that does not include working on past traumatic memories, it will be more focused on present and future.
Arm Title
Treatment as Usual
Arm Type
Active Comparator
Arm Description
30 participants will be randomized to this group. They will continue only the medical treatment for Hashimoto their doctor prescribed to them.
Intervention Type
Behavioral
Intervention Name(s)
Eye Movement Desensitization and Reprocessing
Intervention Description
The first session will be assigned to the assessment and the exploration of the personal history and for presenting the method to the client. Then, each case will be conceptualized according to the Model of Two Method Approach and the protocol for the treatment will be used. The procedure will be organized around targeting the most ten disturbing memories which happened before the illness debut, including stressful or traumatic memories from childhood. The rationale behind this approach is that adverse events leave traces in the neural network of an individual in such a way that these cause a variety of emotional or cognitive symptoms. If we consider the illness as being also a "symptom" of a traumatic past, then we expect that by accessing the dysfunctionally stored memory and stimulating the innate processing system, the symptoms of the illness diminish.
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
The participants randomised in this group will receive a protocol focused only on present and future (present symptoms, daily problems, future projects). The psychologist will lead the discussion anywhere except for the past.
Intervention Type
Drug
Intervention Name(s)
Treatment as Usual
Intervention Description
The participants randomised in this group will continue taking the classical treatment prescribed for Hashimoto (Levothyroxine)
Primary Outcome Measure Information:
Title
Measurement of anti-thyroid peroxidase levels (anti-TPO)
Description
Measurement of anti-thyroid peroxidase in adults with Hashimoto at baseline, post-treatment and follow-up, after trauma therapy with EMDR
Time Frame
baseline to 6 months
Title
Measurement of thyroglobulin levels (TgAb)
Description
Measurement of thyroglobulin antibodies levels in adults with Hashimoto at baseline, post-treatment and follow-up, after trauma therapy with EMDR
Time Frame
baseline to 6 months
Secondary Outcome Measure Information:
Title
State-Trait Anger Expression Inventory
Description
Perceptions about anger expression in adults with Hashimoto will be measured at baseline, post-treatment and follow-up, after EMDR treatment. The inventory assesses a various area of anger and the traits of experiencing anger. Participants are asked to respond to 44 items using a 4-point scale ("Not at all" to "Almost always").
Time Frame
Baseline to 6 months
Title
Toronto Alexithymia Scale
Description
Perceptions about alexithymia will be measured at baseline, post-treatment and follow-up, after EMDR treatment. Toronto Alexithymia Scale is a 20 item self-report instrument, with each item rated on a 5-point Likert scale ranging from 1 (Strongly Disagree) to 5 (Strongly Agree).
Time Frame
Baseline to 6 months
Title
Dissociative Experiences Scale
Description
Perceptions about the levels of dissociation will be measured at baseline, post-treatment and follow-up, after EMDR treatment. The instrument is a self-assessment questionnaire used to screen for dissociative symptoms. It consists of 28 items that assess the frequency and severity of a wide range of dissociative experiences using an eleven-point visual analog scale (0%-100%).
Time Frame
Baseline to 6 months
Title
The Depression Anxiety Stress Scales
Description
Perceptions about depression, anxiety and stress levels will be measured at baseline, post-treatment and follow-up, after EMDR treatment. The instrument is a set of three self-report scales designed to measure the emotional states of depression, anxiety, and stress. Each of the three scales contains seven items.
Time Frame
Baseline to 6 months
Title
The World Health Organization Quality of Life
Description
Perceptions about the quality of life will be measured at baseline, post-treatment and follow-up, after EMDR treatment. The instrument is a 26-item self-report tapping into the following broad domains: physical health, psychological health, social relationships, and environment.
Time Frame
Baseline to 6 months
Other Pre-specified Outcome Measures:
Title
The Difficulties in Emotion Regulation Scale
Description
Perceptions of the emotion regulation will be measured at baseline, post-treatment and follow-up, after EMDR treatment. The instrument is designed to assess clinically relevant difficulties in emotion regulation.
Time Frame
Baseline to 6 months
Title
The Outcome Rating Scale and Session Rating scale
Description
This scales are very brief and feasible measures for tracking client well-being and the quality of the therapeutic alliance. The Outcome Rating Scale will be completed by the participant at the beginning of each of the 12 sessions. The Session Rating Scale will be completed by the participant at the end of each of the 12 sessions.
Time Frame
Baseline to 6 months
Title
Intent-to-Attend Scale
Description
The scale is a single-item measure. Participants rate their intention on a nine-point Likert scale, at the end of each session.
Time Frame
Baseline to 6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: aged 18-55 years; confirmed autoimmune thyroiditis diagnosis at least one biological marker Anti-thyroid peroxidase (anti-TPO) antibodies or thyroglobulin antibodies (TgAb) exceeds the reference range Exclusion Criteria: the presence of psychotic symptoms currently receiving another form of psychological treatment; under psychotropic medication; neurodevelopmental disorders (intellectual disability, communication disorders, autism spectrum disorders, ADHD); neurocognitive disorders; substance abuse; serious legal or health issues that would prevent from regularly attending patients with autoimmune thyroiditis with biological markers within the reference range
Facility Information:
Facility Name
University of Bucharest
City
Bucharest
Country
Romania

12. IPD Sharing Statement

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Eye Movement Desensitization and Reprocessing on Autoimmune Thyroiditis in Adults

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