Psychological and Glycemic Outcomes Associated with EMDR Therapy in Children and Adolescents with Type 1 Diabetes Mellitus: A Retrospective Comparative Study

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.