Vallières Annie, Morin Charles M, Guay Bernard
Ecole de psychologie, Université Laval, Pavillon FAS, Québec, Canada G1K 7P4.
Behav Res Ther. 2005 Dec;43(12):1611-30. doi: 10.1016/j.brat.2004.11.011.
This study explores the efficacy of sequential treatments involving medication and cognitive behavioral treatment (CBT) for primary insomnia. Seventeen participants took part in a multiple baseline design and were assigned to: (a) medication for 5 weeks, followed by combined medication plus CBT for 5 weeks; (b) combined treatment for 5 weeks, followed by CBT alone; or (c) CBT alone. Each treatment sequence produced significant sleep improvements, but at different points in time. For the first sequence, most of the sleep improvement was obtained after the introduction of CBT, while for the other sequence and CBT alone, improvement appeared during the first weeks. These results suggest that sleep improvement seems affected by the way treatments are combined. Also, a sequence beginning with a combined treatment followed by CBT alone seems to produce the best outcome. Additional research should be conducted with larger samples to determine the most effective sequence.
本研究探讨了药物治疗与认知行为疗法（CBT）相结合的序贯治疗对原发性失眠的疗效。17名参与者参与了多基线设计，并被分配到：（a）药物治疗5周，随后药物联合CBT治疗5周；（b）联合治疗5周，随后单独进行CBT；或（c）单独进行CBT。每个治疗序列都显著改善了睡眠，但在不同的时间点。对于第一个序列，大部分睡眠改善是在引入CBT后获得的，而对于其他序列和单独的CBT，改善在最初几周就出现了。这些结果表明，睡眠改善似乎受治疗组合方式的影响。此外，从联合治疗开始，随后单独进行CBT的序列似乎产生了最佳效果。应该用更大的样本进行进一步研究，以确定最有效的序列。
