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Title: | Cognitive behavioural therapy for insomnia as an early intervention of mood disorders with comorbid insomnia : a randomized controlled trial | Authors: | Chung, KF Lee, CT Au, CH Kam, KY Lee, CK Yeung, WF Lau, EYY Ho, FYY Ho, LM |
Issue Date: | Feb-2024 | Source: | Early intervention in psychiatry, Feb. 2024, v. 18, no. 2, p. 82-93 | Abstract: | Objective: To evaluate the effectiveness of small-group nurse-administered cognitive behavioural therapy for insomnia (CBTI) as an early intervention of mood disorders with comorbid insomnia. Methods: A total of 200 patients with first-episode depressive or bipolar disorders and comorbid insomnia were randomized in a ratio of 1:1 to receiving 4-session CBTI or not in a routine psychiatric care setting. Primary outcome was Insomnia Severity Index. Secondary outcomes included response and remission status; daytime symptomatology and quality of life; medication burden; sleep-related cognitions and behaviours; and the credibility, satisfaction, adherence and adverse events of CBTI. Assessments were conducted at baseline, 3, 6, and 12-month. Results: Only a significant time-effect but no group-by-time interaction was found in the primary outcome. Several secondary outcomes had significantly greater improvements in CBTI group, including higher depression remission at 12-month (59.7% vs. 37.9%, χ2 = 6.57, p = .01), lower anxiolytic use at 3-month (18.1% vs. 33.3%, χ2 = 4.72, p = .03) and 12-month (12.5% vs. 25.8%, χ2 = 3.26, p = .047), and lesser sleep-related dysfunctional cognitions at 3 and 6-month (mixed-effects model, F = 5.12, p = .001 and .03, respectively). Depression remission rate was 28.6%, 40.3%, and 59.7% at 3, 6, and 12-month, respectively in CBTI group and 28.4%, 31.1%, and 37.9%, respectively in no CBTI group. Conclusion: CBTI may be a useful early intervention to enhance depression remission and reduce medication burden in patients with first-episode depressive disorder and comorbid insomnia. |
Keywords: | Chinese Cognitive behavioural therapy Comorbid insomnia First-episode Mood disorders |
Publisher: | John Wiley & Sons, Inc. | Journal: | Early intervention in psychiatry | ISSN: | 1751-7885 | EISSN: | 1751-7893 | DOI: | 10.1111/eip.13435 | Rights: | © 2023 The Authors. Early Intervention in Psychiatry published by John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. The following publication Chung, K.-F., Lee, C.-T., Au, C.-H., Kam, K.-Y., Lee, C.-K., Yeung, W.-F., Lau, E. Y. Y., Ho, F. Y.-Y., & Ho, L.-M. (2024). Cognitive behavioural therapy for insomnia as an early intervention of mood disorders with comorbid insomnia: A randomized controlled trial. Early Intervention in Psychiatry, 18(2), 82–93 is available at https://doi.org/10.1111/eip.13435. |
Appears in Collections: | Journal/Magazine Article |
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