Cognitive-behavioral treatment of insomnia and depression in adolescents: A pilot randomized trial. (June 2015)

• Record Type: Journal Article
• Authors: Clarke, Greg; McGlinchey, Eleanor L.; Hein, Kerrie; Gullion, Christina M.; Dickerson, John F.; Leo, Michael C.; Harvey, Allison G.
• Is Part Of: Behaviour research and therapy. Volume 69(2015)
• Page Start: 111
• Page End: 118
• Publication Date: 2015-06
• Subjects: Depression -- Insomnia -- CBT -- Adolescents -- Treatment; Cognitive therapy -- Periodicals; Psychotherapy -- Periodicals; 616.891
• DOI: 10.1016/j.brat.2015.04.009
• Languages: English
• ISSNs: 0005-7967

Abstract

Abstract: We tested whether augmenting conventional depression treatment in youth by treating sleep issues with cognitive behavioral therapy for insomnia (CBT-I) improved depression outcomes. We randomized youth 12–20 years of age to 10 weekly sessions of a sleep hygiene control condition (SH) combined with CBT for depression (CBT-D) (n = 20), or an experimental condition consisting of CBT-I combined with CBT-D (n = 21). We assessed outcomes through 26 weeks of follow-up and found medium-large effects favoring the experimental CBT-I arm on some sleep outcomes (actigraphy total sleep time and Insomnia Severity Index "caseness") and depression outcomes (higher percentage recovered, faster time to recovery), but little effect on other measures. Total sleep time improved by 99 min from baseline to week 12 in the CBT-I arm, but not in the SH arm. In addition, our pilot yielded important products to facilitate future studies: the youth-adapted CBT-I program; the study protocol; estimates of recruitment, retention, and attrition; and performance and parameters of candidate outcome measures. ClinicalTrials.gov IdentifierNCT00949689 Highlights: Unipolar depression is a common and impairing disorder in adolescence. Insomnia is commonly comorbid with depression. Adding CBT for insomnia to CBT for depression, improved sleep and depression outcomes with medium to large effect sizes.