Treating Sleep Problems in Young People at Ultra-High Risk of Psychosis: A Feasibility Case Series.
Treating Sleep Problems in Young People at Ultra-High Risk of Psychosis: A Feasibility Case Series.
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DOI：
10.1017/s1352465817000601
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发表时间：
2018-05
影响因子：
1.8
通讯作者：
Waite F
中科院分区：
文献类型：
--
作者：
Bradley J;Freeman D;Chadwick E;Harvey AG;Mullins B;Johns L;Sheaves B;Lennox B;Broome M;Waite F
背景：我们认为睡眠障碍可能是精神病经历发展和维持的一个促成因素。最近的一系列随机对照干预研究表明，认知行为方法可以改善有精神病经历的人的睡眠。然而，心理干预对改善睡眠的影响尚未在精神病超高风险的年轻人中进行评估。改善睡眠可以防止以后转变为心理健康障碍。目的：评估针对处于精神病超高风险的年轻人的睡眠障碍进行干预的可行性和可接受性。方法：从NHS心理健康服务中寻找患者。12名患有睡眠问题的精神病超高风险的年轻人接受了8次适应性CBT干预。核心治疗技术是刺激控制，昼夜节律调整，并调节白天的活动。参与者在治疗前后和一个月的随访中进行了评估。结果：所有符合条件的患者都同意参加研究。11名患者完成了干预，1名患者在两次治疗后退出。在完成治疗的患者中，出席率为89%，平均出席7.6次会议（SD = 0.5）。在睡眠方面有很大的效应量改善。治疗后，6名患者低于临床失眠的推荐临界值。负面情绪和精神病经历也有所改善。结论：这项非对照可行性研究表明，治疗处于精神病超高水平的年轻人的睡眠问题是可行的，可接受的，并且可能与临床益处有关。
Background: Our view is that sleep disturbance may be a contributory causal factor in the development and maintenance of psychotic experiences. A recent series of randomized controlled intervention studies has shown that cognitive-behavioural approaches can improve sleep in people with psychotic experiences. However, the effects of psychological intervention for improving sleep have not been evaluated in young people at ultra-high risk of psychosis. Improving sleep might prevent later transition to a mental health disorder. Aims: To assess the feasibility and acceptability of an intervention targeting sleep disturbance in young people at ultra-high risk of psychosis. Method: Patients were sought from NHS mental health services. Twelve young people at ultra-high risk of psychosis with sleep problems were offered an eight-session adapted CBT intervention for sleep problems. The core treatment techniques were stimulus control, circadian realignment, and regulating day-time activity. Participants were assessed before and after treatment and at a one month follow-up. Results: All eligible patients referred to the study agreed to take part. Eleven patients completed the intervention, and one patient withdrew after two sessions. Of those who completed treatment, the attendance rate was 89% and an average of 7.6 sessions (SD = 0.5) were attended. There were large effect size improvements in sleep. Post-treatment, six patients fell below the recommended cut-off for clinical insomnia. There were also improvements in negative affect and psychotic experiences. Conclusion: This uncontrolled feasibility study indicates that treating sleep problems in young people at ultra-high of psychosis is feasible, acceptable, and may be associated with clinical benefits.