Psychological and glycemic outcomes associated with EMDR therapy in children and adolescents with Type 1 Diabetes Mellitus: A retrospective comparative study
EMDR therapy was associated with greater improvement than standard psychiatric follow-up in separation anxiety, depressive symptoms, and overall anxiety burden, and, notably, with a significantly greater reduction in mean blood glucose.
Article Abstract
“Background: Children and adolescents with type 1 diabetes mellitus (T1DM) are at increased risk of comorbid anxiety and depressive symptoms, which can adversely affect glycemic control. Eye Movement Desensitization and Reprocessing (EMDR) therapy has demonstrated efficacy for trauma-related and anxiety symptoms, but its use in pediatric T1DM populations has been rarely studied.
Methods: In this retrospective comparative study, 52 children and adolescents with T1DM and comorbid anxiety/depressive symptoms were classified into two equally sized groups according to whether they had received EMDR, based on real-world clinical decision-making rather than randomization: an EMDR group (n = 26) and a comparison group receiving standard psychiatric follow-up without EMDR (n = 26). Anxiety and depressive symptoms were assessed with the Revised Child Anxiety and Depression Scale (RCADS; standardized T-scores) before and after the intervention period. Three-month average blood glucose and mean daily insulin injection frequency were recorded before and after the same period. Group differences were analyzed using two-way repeated-measures analysis of variance (time × group) with Fisher’s LSD post hoc comparisons; baseline continuous and categorical variables were compared using the independent-samples t-test and chi-square test, respectively.
Results: The EMDR and comparison groups did not differ significantly in age, sex, or other sociodemographic/clinical characteristics (all p > 0.05); baseline RCADS scores were comparable between groups except for obsessive–compulsive symptoms, which were higher in the comparison group (62.92 ± 11.24 vs. 55.38 ± 12.76; p = 0.020). There was a significant main effect of time (i.e., an overall improvement averaged across both groups) for all eight RCADS subscales (all p ≤ 0.02); within-group comparisons showed significant improvement in the EMDR group on every subscale, whereas the comparison group did not improve significantly on depression (p = 0.130) or total anxiety-plus-depression (p = 0.247). A significant time × group interaction, indicating significantly greater improvement in the EMDR group, was found for separation anxiety (p = 0.033), depression (p < 0.001), total anxiety (p = 0.011), and total anxiety-plus-depression (p = 0.015); interactions for generalized anxiety, panic, social phobia, and obsessive–compulsive symptoms did not reach significance (p = 0.07–0.86). There was also a significant main effect of time for mean blood glucose and for insulin injection frequency; however, within-group comparisons showed a significant reduction in the EMDR group only, with no significant change in the comparison group for either measure (p = 0.719 and p = 0.163, respectively). A significant time × group interaction confirmed a substantially greater reduction in the EMDR group for both mean blood glucose (F = 40.45, p < 0.001) and insulin injection frequency (F = 19.45, p < 0.001).
Conclusions: EMDR therapy was associated with greater improvement than standard psychiatric follow-up in separation anxiety, depressive symptoms, and overall anxiety burden, and, notably, with a significantly greater reduction in mean blood glucose; a parallel pattern was observed for insulin injection frequency, a secondary, treatment-related measure that should be interpreted with caution. Given the retrospective, non-randomized design and the post hoc identification of these outcome patterns, these findings should be interpreted as exploratory and hypothesis-generating, warranting confirmation in prospective controlled trials.
Highlights:
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In children and adolescents with type 1 diabetes, EMDR therapy was associated with significantly greater improvement than standard psychiatric follow-up in separation anxiety, depressive symptoms, and overall anxiety burden, based on significant time × group interactions and within-group comparisons.
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EMDR therapy was also associated with a significantly greater reduction in mean blood glucose than standard psychiatric follow-up, which showed no significant within-group change over the same period; a similar pattern was observed for insulin injection frequency, a secondary, treatment-related measure.
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EMDR may be a valuable adjunctive psychological intervention for anxiety and depressive symptoms in youth with type 1 diabetes, with a possible additional association with reduced blood glucose that warrants prospective confirmation.
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Prospective, adequately powered randomized controlled trials with longer follow-up are needed to confirm EMDR’s efficacy and clarify its relationship with metabolic outcomes”
—Description from publisher
Article Access
Open Access
Arslanoğlu, S., Karadağ, M., & Çalışgan, B. (2026). Psychological and glycemic outcomes associated with EMDR therapy in children and adolescents with Type 1 Diabetes Mellitus: A retrospective comparative study. Children, 13(9), 1262. https://doi.org/10.3390/children13091262(opens in new tab)
Date
September 17, 2026
Creator(s)
Evgenia Gkintoni, Elias Kourkoutas, Vasiliki Yotsidi
Contributor(s)
Pilios Dimitris Stavrou, Dimitra Prinianaki
Topics
PTSD
Client Population
Adolescents, Children
Extent
33 pages
Publisher
MDPI
Rights
Copyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
APA Citation
Gkintoni, E., Kourkoutas, E., Yotsidi, V., Stavrou, P. D., & Prinianaki, D. (2024). Clinical efficacy of psychotherapeutic interventions for post-traumatic stress disorder in children and adolescents: A systematic review and analysis. Children, 11(5), 579. Open access: https://doi.org/10.3390/children11050579
Audience
EMDR Therapists, Other Mental Health Professionals
Language
English
Content Type
Article, Meta-analyses/Systematic Reviews, Peer-Reviewed
Access Type
External Resource, Open Access