The Public Mental Health Laboratory, Department of Psychology, The Chinese University of Hong Kong, Hong Kong.
Department of Psychology, The University of Hong Kong, Hong Kong.
J Affect Disord. 2020 Mar 15;265:287-304. doi: 10.1016/j.jad.2020.01.062. Epub 2020 Jan 15.
Sleep disturbances commonly occur in patients with depression. Insomnia is considered not only a symptom of but also a risk factor for depression. Psychological treatments for insomnia have been demonstrated to be efficacious in alleviating depressive symptoms. This meta-analysis examined the effect of self-help cognitive behavioral therapy for insomnia (CBT-I) in treating depressive symptoms.
A systematic review was performed up to April 2019 in 6 major electronic databases. The literature search retrieved 4190 potentially relevant citations; 30 randomized controlled trials (total N = 5945) that compared self-help CBT-I vs. waiting-list (WL), routine care, no treatment, individual cognitive behavioral therapy (CBT), group CBT and placebo were included in the current review.
Random effects models showed significant reduction in self-report depressive symptoms (Hedges' g = 0.35; 95% CI: -0.47, -0.23) and insomnia symptoms (Hedges' g = 0.79; 95% CI: -0.56, -1.03) in the self-help CBT-I group when compared to the WL/routine care/no treatment/psychoeducation control group.
The findings should be interpreted with caution due to potential publication bias.
CBT-I appears to be efficacious in treating depressive symptoms. Given the current results and study limitations, large-scale, high-quality trials that specifically target individuals with a clinical diagnosis of depression are warranted in the future.
睡眠障碍在抑郁症患者中很常见。失眠不仅被认为是抑郁症的症状之一，也是其危险因素之一。针对失眠的心理治疗已被证明能有效缓解抑郁症状。本荟萃分析考察了自助认知行为疗法治疗失眠（CBT-I）对抑郁症状的疗效。
截至 2019 年 4 月，我们在 6 个主要电子数据库中进行了系统评价。文献检索共检索到 4190 篇可能相关的引文；纳入了 30 项随机对照试验（共 N=5945），比较了自助 CBT-I 与等待名单（WL）、常规护理、无治疗、个体认知行为疗法（CBT）、团体 CBT 和安慰剂。
随机效应模型显示，与 WL/常规护理/无治疗/心理教育对照组相比，自助 CBT-I 组的自评抑郁症状（Hedges' g=0.35；95% CI：-0.47，-0.23）和失眠症状（Hedges' g=0.79；95% CI：-0.56，-1.03）显著降低。
由于可能存在发表偏倚，因此应谨慎解释这些发现。
CBT-I 似乎对治疗抑郁症状有效。鉴于目前的结果和研究局限性，未来有必要开展针对有临床诊断为抑郁症的个体的大规模、高质量试验。
