Depressed adolescents with childhood trauma often present with more severe symptoms and are insensitive to drugs. Eye movement desensitization and reprocessing (EMDR) plays a unique role in the treatment of trauma-related mental disorders. It has been gradually used in the treatment of depression and has achieved certain results recently, but there are few related studies in China.

To assess whether EMDR has better efficacy than sertraline in the treatment of depressed adolescents with childhood trauma using a comparative analysis, providing scientific evidence for further promoting clinical application of EMDR.

Sixty depressed adolescents with childhood trauma were recruited from Psychological Clinic, Affiliated Hospital of Zunyi Medical University from December 2020 to February 2022, and equally randomized into a sertraline group and an EMDR group. Sertraline group received a eight-week treatment with sertraline: the dose was 50 mg/d in the first week and gradually increased to 100 mg/d in the second week, and could be increased to 200 mg/d at the end of the fourth week if the patients had negative ideas or self-injurious behavior. The EMDR group received EMDR treatment, once a week, for a total of 8 weeks. The Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Connor-Davidson Resilience Scale (CD-RISC) were used to evaluate the psychological status of the two groups before treatment, four weeks and eight weeks after treatment.

Except for five dropouts, the remaining cases who completed the trial were finally included, including 28 in the sertraline group and 27 in the EMDR group. The treatment type and treatment duration had interactive effects on the BDI, BAI and CD-RISC scores of the two groups (P<0.05). The treatment duration had significant main effects on the BDI, BAI and CD-RISC scores of the two groups (P<0.05). The treatment type had significant main effects on BAI and CD-RISC scores of the two groups (P<0.05), but produced no significant effects on the BDI scores (P>0.05). EMDR group had higher average CD-RISC score than sertraline group at four weeks after treatment (P<0.05). EMDR group had higher average CD-RISC score, and lower average BDI and BAI scores than sertraline group at eight weeks after treatment (P<0.05). In the sertraline group, the average BDI score at eight weeks after treatment was much lower than that at baseline or four weeks after treatment (P<0.05), the BDI score after 4 weeks of sertraline treatment was lower than that before treatment (P<0.05), and the average BAI score at eight weeks after treatment was much lower than that at basetime (P<0.05). In the EMDR group, the average BDI and BAI scores decreased significantly while the average CD-RISC score increased significantly at both four and eight weeks after treatment compared with baseline levels (P<0.05). And compared with four-week treatment, eight-week treatment lowered the average BDI and BAI scores more significantly, and increased the average CD-RISC score more significantly (P<0.05) .

Sertraline could partially improve depression and anxiety in depressed adolescents with childhood trauma, but had no significant improvement of psychological elasticity. In contrast, EMDR could effectively improve the depression and anxiety as well as psychological elasticity, so it could be used as the preferred treatment.

伴童年创伤的青少年抑郁症患儿的抑郁症状常更严重，且对药物不敏感。眼动脱敏与再加工（EMDR）在治疗创伤有关的心理疾病中发挥了其独特的优势，近年来也逐渐用于抑郁症的治疗并取得了一定的成果，但国内相关研究较少。

比较EMDR和舍曲林治疗伴童年创伤的青少年抑郁症患儿的效果差异，以探索更优的临床治疗方案，并为进一步推广EMDR的临床应用提供科学数据。

收集2020年12月至2022年2月就诊于遵义医科大学附属医院心理门诊的60例伴童年创伤的青少年抑郁症患儿为研究对象。依据随机数字表法分为舍曲林治疗组和EMDR治疗组，各30例。舍曲林治疗组单纯服用盐酸舍曲林片，第1周剂量为50 mg/d，第2周逐渐加量至100 mg/d，在第4周末若存在消极观念或自伤行为可将舍曲林加量至200 mg/d，总疗程为8周。EMDR治疗组进行EMDR治疗，1次/周，总疗程为8周。采用贝克抑郁自评量表（BDI）、贝克焦虑自评量表（BAI）和心理弹性量表（CD-RISC）对两组患儿治疗前、治疗4周后、治疗8周后的心理情况进行评价。

研究过程中存在5例脱落病例，最终完成试验55例，其中舍曲林治疗组28例，EMDR治疗组27例。时间和组间对两组患儿BDI、BAI、CD-RISC评分存在交互作用（P<0.05）；时间对两组患儿BDI、BAI、CD-RISC评分主效应显著（P<0.05）；组间对两组患儿BAI、CD-RISC评分主效应显著（P<0.05）；组间对BDI评分主效应不显著（P>0.05）。治疗4周后EMDR治疗组患儿CD-RISC评分高于舍曲林治疗组（P<0.05）。治疗8周后EMDR治疗组患儿CD-RISC评分高于舍曲林治疗组，BDI、BAI评分低于舍曲林治疗组（P<0.05）。舍曲林治疗组患儿治疗8周后BDI评分低于治疗前、治疗4周后（P<0.05）；舍曲林治疗组治疗4周后BDI评分低于治疗前（P<0.05）；舍曲林治疗组患儿治疗8周后BAI评分低于治疗前（P<0.05）。EMDR治疗组患儿治疗4、8周后BDI、BAI评分均低于治疗前，CD-RISC评分高于治疗前（P<0.05）；EMDR治疗组患儿治疗8周后BDI、BAI评分均低于治疗4周后，CD-RISC评分高于治疗4周后（P<0.05）。

舍曲林能部分改善伴童年创伤的青少年抑郁症患儿的抑郁和焦虑情绪，但对于心理弹性的提升效果不显著；EMDR不仅能够有效改善伴童年创伤抑郁症患儿的抑郁和焦虑情绪，还能提升心理弹性，可作为其优选治疗方案。