Moderators of Cognitive Behavioral Treatment for Insomnia on Depression and Anxiety Outcomes.
Moderators of Cognitive Behavioral Treatment for Insomnia on Depression and Anxiety Outcomes.
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失眠症认知行为治疗对抑郁和焦虑结果的调节因素。
DOI：
10.1007/s11920-022-01326-3
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发表时间：
2022-03
影响因子：
6.7
通讯作者：
Asarnow LD
中科院分区：
文献类型：
--
作者：
Mirchandaney R;Barete R;Asarnow LD
我们重点回顾了有充分把握的随机对照试验，介绍了最近关于失眠症认知行为疗法（CBT-I）改善失眠症患者抑郁和焦虑结局的潜力的研究，这些患者患有以下共病精神障碍：重度抑郁症（MDD），广泛性焦虑症（GAD）或创伤后应激障碍（PTSD）。我们还研究了CBT-I对这一人群中抑郁和焦虑结果的潜在调节因素。尽管合并症发生率很高，但目前对MDD、GAD和PTSD的行为和药物治疗并不能显著靶向或改善失眠症状;即使在经历缓解的患者中，残留失眠也非常常见。失眠在抑郁和焦虑的发生和维持中起着关键作用，用CBT-I治疗失眠可能会改善MDD、GAD和PTSD患者的总体结局。CBT-I在改善共病精神障碍患者的失眠症状方面上级传统的抑郁/焦虑治疗。关于CBT-I（单独使用或结合抑郁/焦虑治疗）是否能有效改善总体MDD、GAD和PTSD结局，结果好坏参半。晚上的昼夜节律偏好和抑郁/焦虑症状的严重程度可能会缓和CBT-I对抑郁和焦虑结果的影响。在线版本包含补充材料，可通过10.1007/s11920-022-01326-3获取。
With a focus on reviewing adequately powered randomized controlled trials, we present recent research on the potential of cognitive behavioral therapy for insomnia (CBT-I) to improve depression and anxiety outcomes among patients with insomnia and one of the following comorbid psychiatric disorders: major depressive disorder (MDD), generalized anxiety disorder (GAD), or posttraumatic stress disorder (PTSD). We also examine potential moderators of CBT-I on depression and anxiety outcomes in this population. Despite high comorbidity rates, current behavioral and pharmacological treatments for MDD, GAD, and PTSD do not substantially target or improve insomnia symptoms; residual insomnia is exceedingly common even among patients who experience remission. Insomnia plays a critical role in the onset and maintenance of depression and anxiety, and treating insomnia with CBT-I may improve global outcomes for patients with MDD, GAD, and PTSD. CBT-I is superior to traditional depression/anxiety treatment in improving insomnia symptoms among patients with comorbid psychiatric disorders. Results are mixed on whether CBT-I (either alone or augmented with depression/anxiety treatment) is effective in improving overall MDD, GAD, and PTSD outcomes. Evening circadian preference and depression/anxiety symptom severity may moderate the effect of CBT-I on depression and anxiety outcomes. The online version contains supplementary material available at 10.1007/s11920-022-01326-3.
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