Ugurlu Mustafa, Karakas Ugurlu Gorkem, Kabadayi Sahin Esra, Kamis Gulsum Zuhal, Caykoylu Ali
Department of Psychiatry, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey.
Department of Psychiatry, Ankara Bilkent City Hospital, Ankara, Turkey.
Braz J Psychiatry. 2025;47:e20243623. doi: 10.47626/1516-4446-2024-3623. Epub 2024 Aug 5.
Sleep problems are common in patients with psychotic disorders, especially schizophrenia. Although pharmacological methods are at the forefront of treatment, they have some drawbacks. Cognitive behavioral therapy for insomnia (CBT-I) is an option for the treatment of individuals with insomnia; in recent years, interest in its use in patients with psychotic disorders has been increasing. This meta-analysis aims to evaluate the effectiveness of CBT-I for sleep problems in patients with psychotic disorders.
A systematic search of the PubMed, Scopus, and EBSCO (MEDLINE) databases was conducted to identify relevant studies. The inclusion criteria were randomized controlled trials (RCTs) and uncontrolled studies that focused on participants diagnosed with schizophrenia, schizoaffective disorder, delusional disorder, psychotic disorders not otherwise specified, bipolar disorders, or unipolar depression with psychotic features, who had had sleep problems for at least 1 month, and who were receiving treatment. The initial search yielded 246 studies, of which eight were ultimately selected for meta-analysis after screening and applying inclusion and exclusion criteria. Statistical analysis was conducted in the R software environment.
CBT-I significantly ameliorates insomnia and sleep quality in patients with psychotic disorders in both the short and long term. Additionally, CBT-I leads to significant improvement in psychotic symptoms in the short-term period and contributes significantly to improvement in mental well-being in both short- and long-term follow-up.
CBT-I is an effective, valuable method for sleep problems in patients with psychotic disorders. Its widespread use for this purpose is recommended.
睡眠问题在精神障碍患者中很常见，尤其是精神分裂症患者。尽管药物治疗方法处于治疗的前沿，但它们存在一些缺点。失眠认知行为疗法（CBT-I）是治疗失眠个体的一种选择；近年来，其在精神障碍患者中的应用受到越来越多的关注。本荟萃分析旨在评估CBT-I对精神障碍患者睡眠问题的有效性。
对PubMed、Scopus和EBSCO（MEDLINE）数据库进行系统检索，以识别相关研究。纳入标准为随机对照试验（RCT）和非对照研究，研究对象为被诊断为精神分裂症、分裂情感性障碍、妄想性障碍、未另行指定的精神障碍、双相情感障碍或伴有精神病性特征的单相抑郁症，有睡眠问题至少1个月且正在接受治疗的患者。初步检索得到246项研究，经过筛选并应用纳入和排除标准后，最终选择8项进行荟萃分析。在R软件环境中进行统计分析。
CBT-I在短期和长期均能显著改善精神障碍患者的失眠和睡眠质量。此外，CBT-I在短期内可显著改善精神病性症状，在短期和长期随访中均对改善心理健康有显著作用。
CBT-I是治疗精神障碍患者睡眠问题的一种有效且有价值的方法。建议广泛应用于这一目的。
