BASELINE DEPRESSION LEVELS DO NOT AFFECT EFFICACY OF COGNITIVE‐BEHAVIORAL SELF‐HELP TREATMENT FOR INSOMNIA. Issue 2 (18th October 2012)

• Record Type: Journal Article
• Authors: Lancee, Jaap; van den Bout, Jan; van Straten, Annemieke; Spoormaker, Victor I.
• Is Part Of: Depression and anxiety. Volume 30:Issue 2(2013:Feb.)
• Page Start: 149
• Page End: 156
• Publication Date: 2012-10-18
• Subjects: Anxiety -- Periodicals; Depression, Mental -- Periodicals; Depression -- Periodicals; Anxiety -- Periodicals; Anxiety Disorders -- Periodicals; 616.8527005
• DOI: 10.1002/da.22004
• Languages: English
• ISSNs: 1091-4269

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="da22004-sec-0010" sec-type="section"> <title>Background</title> <p> <italic>Cognitive‐behavioral therapy can effectively treat insomnia (</italic> <italic>CBT</italic> <italic>‐</italic> <italic>I</italic> <italic>). Randomized controlled trials have shown efficacy of self‐help</italic> <italic>CBT</italic> <italic>‐</italic> <italic>I</italic>, <italic>but unclear is whether excluding depressive patients boosted treatment effects</italic>.</p> </sec> <sec id="da22004-sec-0020" sec-type="section"> <title>Method</title> <p> <italic>We administered unsupported self‐help</italic> <italic>CBT</italic> <italic>‐</italic> <italic>I</italic> <italic>to insomnia patients with low and high depression levels. Based on the validated</italic> <italic>C</italic> <italic>entre of</italic> <italic>E</italic> <italic>pidemiological</italic> <italic>S</italic> <italic>tudies‐</italic> <italic>D</italic> <italic>epression (</italic> <italic>CES</italic> <italic>‐</italic> <italic>D</italic> <italic>) scale, the internet‐recruited sample (</italic> <italic>N</italic> = <italic>479) was divided into three groups: low depression scores (n = 198), mild depression scores (n = 182), and high depression scores (n = 99). Follow‐ups were 4 and 18 weeks after completion of the treatment</italic>.</p> </sec> <sec id="da22004-sec-0030" sec-type="section"> <title>Results</title> <p> <italic>At 4‐week follow‐up, all groups had a similar amelioration on the primary sleep measures (d = 0.1–0.7;</italic> <italic>P</italic> <<italic> 0.05) and the secondary insomnia ratings (d = 1.2;</italic><italic>P</italic> <<italic> 0.001). The only difference was that the high/mild depression groups had a steeper reduction in depression (d = 1.0–1.1;</italic><italic>P</italic> <<italic> 0.001) and anxiety scores (d = 0.7–0.8;</italic><italic>P</italic> <<italic> 0.001) than the low depression group (depression and anxiety: d = 0.3;</italic><italic>P</italic> <<italic> 0.01), possibly due to floor effects in the latter group. The observed effects were sustained at the 18‐week follow‐up</italic>.</p> </sec> <sec id="da22004-sec-0040" sec-type="section"> <title>Conclusions</title> <p> <italic>This study showed that</italic> <italic>CBT</italic> <italic>‐</italic> <italic>I</italic> <italic>is effective regardless of baseline depression levels. Treating the combination of insomnia and depression is an extra challenge since it is associated with increased sleep problems. These data may help us understand the relationship between insomnia and depression and indicate that self‐help</italic> <italic>CBT</italic> <italic>‐</italic> <italic>I</italic> <italic>may be a promising addition to regular depression treatment</italic>.</p> </sec> </abstract>