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青少年共病精神障碍的失眠认知行为疗法:一项临床试点研究。

Cognitive-behavioral therapy for insomnia in adolescents with comorbid psychiatric disorders: A clinical pilot study.

机构信息

Department of Clinical Neuroscience, Karolinska Institutet, Sweden.

Stress Research Institute, Stockholm University, Sweden.

出版信息

Clin Child Psychol Psychiatry. 2020 Oct;25(4):958-971. doi: 10.1177/1359104520929376. Epub 2020 Jun 17.

DOI:10.1177/1359104520929376
PMID:32985246
Abstract

BACKGROUND

Insomnia is common in adolescents and often comorbid with psychiatric disorders. This study evaluated changes in insomnia, sleep, and comorbid symptoms following cognitive-behavioral therapy for insomnia (CBT-I) in adolescents with comorbid psychiatric disorders and chronic pain.

METHODS

In this non-controlled clinical pilot study, participants ( = 23, 78% female) were recruited from adolescent psychiatry and pediatric pain clinics. Assessments of self-reported insomnia, sleep onset latency, wake after sleep onset, total sleep time, sleep efficiency and depression, anxiety, functional disability, and pain intensity were completed at pre- and post-intervention and 3 months follow-up.

RESULTS

From pre- to post-intervention, statistically significant improvements were found for insomnia symptoms ( < .001;  = 1.63), sleep onset latency ( < .001;  = 1.04), wake after sleep onset ( < .001;  = 0.38), total sleep time ( = .015;  = 0.22), sleep efficiency ( < .001;  = 1.00), depression ( < .001;  = 0.87), and anxiety ( = .001;  = 0.31). Only eight participants reported data at follow-up with maintained improvements for all measures.

CONCLUSION

This study provides support that insomnia symptoms and sleep can improve following CBT-I delivered in a clinical setting and that co-occurring psychiatric symptoms can be reduced. The results should be interpreted with caution due to the uncontrolled conditions and limited sample size. Well-powered clinical trials are needed to validate the suggested effects.

摘要

背景

失眠在青少年中很常见,且常与精神障碍共病。本研究评估了认知行为疗法治疗共病精神障碍和慢性疼痛的青少年失眠症(CBT-I)后失眠、睡眠和共病症状的变化。

方法

在这项非对照的临床初步研究中,参与者( = 23,78%为女性)从青少年精神病学和儿科疼痛诊所招募。在干预前、干预后和 3 个月随访时,完成自我报告的失眠、入睡潜伏期、睡眠后觉醒、总睡眠时间、睡眠效率和抑郁、焦虑、功能障碍和疼痛强度的评估。

结果

从干预前到干预后,失眠症状( < .001;  = 1.63)、入睡潜伏期( < .001;  = 1.04)、睡眠后觉醒( < .001;  = 0.38)、总睡眠时间( = .015;  = 0.22)、睡眠效率( < .001;  = 1.00)、抑郁( < .001;  = 0.87)和焦虑( = .001;  = 0.31)均有统计学显著改善。只有 8 名参与者在随访时报告了数据,所有指标均保持改善。

结论

本研究提供了支持,即 CBT-I 在临床环境中实施后,失眠症状和睡眠可以得到改善,并且共病的精神症状可以得到减轻。由于对照条件和有限的样本量,结果应谨慎解释。需要进行大规模的临床试验来验证所建议的效果。

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