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互联网 delivered 认知行为疗法青少年失眠伴发精神疾病:一项非随机试验。

Internet-delivered cognitive behaviour therapy for adolescents with insomnia comorbid to psychiatric conditions: A non-randomised trial.

机构信息

Department of Neuroscience, Uppsala University, Uppsala, Sweden.

Child and Adolescent Psychiatric Services, Uppsala University Hospital, Uppsala, Sweden.

出版信息

Clin Child Psychol Psychiatry. 2021 Apr;26(2):475-489. doi: 10.1177/1359104520978464. Epub 2020 Dec 18.

Abstract

Insomnia is highly prevalent among adolescents with psychiatric conditions and is known to aggravate psychiatric symptoms. Research on cognitive behaviour therapy for adolescents with comorbid insomnia (CBT-I) is still limited. The aim of this study was to investigate feasibility and preliminary effects of internet-delivered CBT for adolescents with insomnia comorbid to a psychiatric condition. Twenty-one patients (13-17 years) with comorbid insomnia were recruited from Child and Adolescent Psychiatry. All patients received 7 weeks of internet-delivered CBT-I with therapist support. Outcomes were assessed at baseline, post-treatment, and at a 4-month follow-up. The proportion of completed assessments was overall acceptable. Participants on average completed 4.48 ( = 1.97) of the seven treatment modules and therapists on average spent 12.80 minutes ( = 6.23) per patient and week. Results showed large statistically significant improvements on insomnia severity, sleep efficiency, sleep onset latency and sleep quality. Medium to large improvements were also seen on the psychiatric symptoms of depression, obsessive-compulsive symptoms, interpersonal sensitivity, paranoid ideation and psychoticism. These findings indicate that internet-delivered CBT is feasible and potentially promising for improving sleep and reducing psychiatric symptoms in adolescent psychiatric patients with insomnia and co-morbid psychiatric disorders. A larger randomised trial is warranted to verify these preliminary results.

摘要

失眠在患有精神疾病的青少年中非常普遍,并且已知会加重精神症状。关于共病失眠的青少年认知行为疗法(CBT-I)的研究仍然有限。本研究旨在调查针对患有精神疾病共病失眠的青少年的互联网提供的 CBT 的可行性和初步效果。从儿童和青少年精神病学中招募了 21 名(13-17 岁)共病失眠的患者。所有患者均接受了 7 周的互联网提供的 CBT-I,并由治疗师提供支持。在基线、治疗后和 4 个月随访时评估结局。完成评估的比例总体上是可以接受的。参与者平均完成了 7 个治疗模块中的 4.48 个( = 1.97),治疗师平均每周为每位患者花费 12.80 分钟( = 6.23)。结果表明,在失眠严重程度、睡眠效率、入睡潜伏期和睡眠质量方面有统计学上显著的显著改善。在抑郁、强迫症状、人际敏感、偏执观念和精神病性等精神症状方面也有中等至较大的改善。这些发现表明,互联网提供的 CBT 在改善睡眠和减少失眠青少年精神疾病患者的精神症状方面是可行的,并且具有潜在的前景。需要进行更大规模的随机试验来验证这些初步结果。

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