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Modified Cognitive Behavioral Therapy for Insomnia in Depressed Adolescents: A Pilot Study
Deirdre A Conroy1, Alison M Czopp1, Dawn M Dore-Stites2
1Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.
Behavioral Sleep Medicine
|March 24, 2017
Summary
This study piloted cognitive behavioral therapy for insomnia (CBTI) in adolescents with depression and insomnia, significantly reducing sleep onset latency and improving sleep quality. The treatment showed positive results, warranting further controlled research for this population.
Area of Science:
- Psychiatry
- Sleep Medicine
- Adolescent Health
Background:
- Adolescents with major depressive disorder (MDD) frequently experience comorbid insomnia.
- Insomnia in depressed adolescents can exacerbate depressive symptoms and negatively impact daily functioning.
- There is a need for effective, targeted interventions for insomnia in this population.
Purpose of the Study:
- To pilot a five-week modified group cognitive behavioral therapy for insomnia (CBTI) in adolescents with MDD and insomnia.
- To assess the feasibility and preliminary efficacy of CBTI in this clinical group.
- To gather data for future controlled trials.
Main Methods:
- An open-label trial involving 16 adolescents (mean age 17.3) with MDD and insomnia.
- Participants completed sleep diaries, actigraphy, Insomnia Severity Index (ISI), Quick Inventory of Depressive Symptomatology (QIDS), and Multidimensional Fatigue Inventory (MFI).
- Paired t-tests and linear mixed modeling were used to analyze pre- and post-treatment data.
Main Results:
- Significant reduction in sleep onset latency from 41 to 18 minutes (p = .004).
- Improvements across treatment in ISI, QIDS, and MFI scores (all p < .001).
- Sleep diaries indicated decreased nighttime wakefulness, increased total sleep time, and improved sleep quality.
Conclusions:
- The pilot CBTI program demonstrated significant improvements in sleep parameters and depressive symptoms in adolescents with MDD and insomnia.
- The high recommendation rate (100% 'yes' or 'definitely yes') suggests patient acceptance.
- Further controlled studies are warranted to confirm these findings and establish CBTI as a standard treatment.
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