Wallsten Daniel, Norell Annika, Anniko Malin, Eriksson Oskar, Lamourín Varja, Halldin Ida, Kindbom Tina, Hesser Hugo, Watkins Edward, Tillfors Maria
Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden.
Faculty of Health and Science, Kristianstad University, Kristianstad, Sweden.
Front Psychol. 2023 Sep 7;14:1196945. doi: 10.3389/fpsyg.2023.1196945. eCollection 2023.
Repetitive negative thinking (RNT) has been described as a maintaining transdiagnostic factor for psychopathology within the areas of depression, anxiety and insomnia. We investigated the effects of rumination-focused cognitive-behaviour therapy (RF-CBT) in a group format at a primary health care centre on symptoms of depression, anxiety, insomnia, RNT, and quality of life. The participants presented clinical symptom levels of worry and at least two disorders among anxiety disorders, major depressive disorder, and insomnia disorder.
A randomised controlled superiority parallel arm trial was used. 73 participants were included and randomised in pairs to either group-administered RF-CBT or a waiting list condition. The primary outcomes were self-rated worry and transdiagnostic symptoms (depression, anxiety, and insomnia). Intention-to-treat analyses of group differences were conducted using linear mixed models. Adverse side effects and incidents were presented descriptively.
Group RF-CBT significantly reduced self-reported insomnia at post-treatment and self-reported insomnia and depression at the 2 month-follow-up, relative to the wait-list control group. There was no significant difference in change in RNT, anxiety, or quality of life.
The current study suggests that group-administered RF-CBT may be effective for insomnia and potentially effective for depression symptomatology. However, the study was underpowered to detect small and moderate effects and the results should therefore be interpreted with caution.
反复消极思维（RNT）被描述为抑郁、焦虑和失眠领域精神病理学的一个维持性跨诊断因素。我们在一家初级保健中心以小组形式研究了专注于沉思的认知行为疗法（RF-CBT）对抑郁、焦虑、失眠、RNT症状及生活质量的影响。参与者呈现出担忧的临床症状水平，且在焦虑症、重度抑郁症和失眠症中至少患有两种疾病。
采用随机对照优势平行组试验。纳入73名参与者并将其配对随机分为接受小组实施的RF-CBT组或等待名单组。主要结局指标为自评担忧和跨诊断症状（抑郁、焦虑和失眠）。使用线性混合模型对组间差异进行意向性分析。对不良副作用和事件进行描述性呈现。
相对于等待名单对照组，小组RF-CBT在治疗后显著降低了自我报告的失眠症状，在2个月随访时显著降低了自我报告的失眠和抑郁症状。RNT、焦虑或生活质量的变化无显著差异。
当前研究表明，小组实施RF-CBT可能对失眠有效，对抑郁症状可能有效。然而，该研究的效能不足以检测小到中等程度的效应，因此对结果的解释应谨慎。
