Centre for Research on Child and Adolescent Mental Health, Karlstad University, SE-651 88 Karlstad, Sweden.
School of Law, Psychology, and Social Work, Örebro University, SE-701 82 Örebro, Sweden; Department of Psychology, Stockholm University, SE-106 91 Stockholm, Sweden.
Behav Res Ther. 2015 Nov;74:80-93. doi: 10.1016/j.brat.2015.09.005. Epub 2015 Sep 30.
To investigate the effects of group CBT for insomnia (CBT-I) on insomnia and depressive symptomatology in a comorbid sample through a randomised controlled trial with a 6 month follow-up.
64 participants were recruited through advertisements and randomised to receive CBT-I or an active control (relaxation training: RT) during four group sessions. Insomnia Severity Index and BDI-II were the primary outcome measures, assessed pre-treatment, post-treatment and at 6 month follow-up. Insomnia and depressive diagnoses, and functional impairment were assessed before and after treatment, whereas sleep diary data was gathered continuously from one week before treatment until after treatment.
CBT-I was more efficient than RT in reducing insomnia severity and equally effective in reducing depressive symptoms, although CBT-I was associated with a higher proportion of remitted persons than RT, regarding both insomnia and depression diagnoses. Also, CBT-I was associated with less functional impairment, shorter sleep onset latency and wake after sleep onset but both treatments had equal improvements of sleep quality, early morning awakenings and total sleep time.
Group CBT-I is an efficient form of insomnia-treatment for people with insomnia comorbid with depressive symptomatology. The mixed results regarding depression outcomes warrants replication and further studies into treatment mechanisms.
通过一项为期 6 个月随访的随机对照试验，研究团体认知行为疗法治疗失眠（CBT-I）对共病患者失眠和抑郁症状的影响。
通过广告招募了 64 名参与者，并将他们随机分配接受 CBT-I 或积极对照（放松训练：RT），共进行 4 次团体治疗。主要结局指标是失眠严重程度指数和贝克抑郁量表第二版（BDI-II），在治疗前、治疗后和 6 个月随访时进行评估。治疗前后评估失眠和抑郁的诊断以及功能障碍，而睡眠日记数据则从治疗前一周持续收集到治疗后。
与 RT 相比，CBT-I 在减轻失眠严重程度方面更有效，在减轻抑郁症状方面同样有效，尽管 CBT-I 与更多的缓解者相关，无论是针对失眠还是抑郁的诊断。此外，CBT-I 与较低的功能障碍、较短的入睡潜伏期和睡眠后觉醒时间相关，但两种治疗方法都能同等改善睡眠质量、早醒和总睡眠时间。
团体认知行为疗法是治疗共病失眠和抑郁症状患者的有效方法。关于抑郁结果的混合结果需要进一步的复制和研究来探讨治疗机制。
