Internet-delivered cognitive behaviour therapy for adolescents with insomnia comorbid to psychiatric conditions: A non-randomised trial

Insomnia is highly prevalent among adolescents with psychiatric conditions and is known to aggravate psychiatric symptoms. Research on cognitive behaviour therapy for adolescents with comorbid insomnia (CBT-I) is still limited. The aim of this study was to investigate feasibility and preliminary effects of internet-delivered CBT for adolescents with insomnia comorbid to a psychiatric condition. Twenty-one patients (13–17 years) with comorbid insomnia were recruited from Child and Adolescent Psychiatry. All patients received 7 weeks of internet-delivered CBT-I with therapist support. Outcomes were assessed at baseline, post-treatment, and at a 4-month follow-up. The proportion of completed assessments was overall acceptable. Participants on average completed 4.48 ( sd = 1.97) of the seven treatment modules and therapists on average spent 12.80 minutes ( sd = 6.23) per patient and week. Results showed large statistically significant improvements on insomnia severity, sleep efficiency, sleep onset latency and sleep quality. Medium to large improvements were also seen on the psychiatric symptoms of depression, obsessive-compulsive symptoms, interpersonal sensitivity, paranoid ideation and psychoticism. These findings indicate that internet-delivered CBT is feasible and potentially promising for improving sleep and reducing psychiatric symptoms in adolescent psychiatric patients with insomnia and co-morbid psychiatric disorders. A larger randomised trial is warranted to verify these preliminary results.

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Metacognitive Therapy versus Cognitive Behaviour Therapy in Adults with Major Depression: A Parallel Single-Blind Randomised Trial

Scientific Reports ◽

10.1038/s41598-020-64577-1 ◽

2020 ◽

Vol 10 (1) ◽

Cited By ~ 2

Author(s):

Pia Callesen ◽

David Reeves ◽

Calvin Heal ◽

Adrian Wells

Keyword(s):

Major Depression ◽

Cognitive Behaviour Therapy ◽

Randomised Trial ◽

Metacognitive Therapy ◽

Behaviour Therapy ◽

Cognitive Behaviour ◽

Single Blind

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P084 Is Cognitive Behaviour Therapy for insomnia (CBTi) responsiveness a function of objective sleep efficiency rather than objective sleep duration?

SLEEP Advances ◽

10.1093/sleepadvances/zpab014.128 ◽

2021 ◽

Vol 2 (Supplement_1) ◽

pp. A48-A48

Author(s):

N Lovato ◽

G Micic ◽

L Lack

Keyword(s):

Sleep Duration ◽

Cognitive Behaviour Therapy ◽

Sleep Onset ◽

Past Research ◽

Severity Index ◽

Sleep Time ◽

Sleep Efficiency ◽

Behaviour Therapy ◽

Cognitive Behaviour ◽

Pre Treatment

Abstract Introduction Past research and our own has not shown a differential response to Cognitive Behaviour Therapy for insomnia (CBTi) based on objective sleep duration. It is valuable to investigate CBTi responsiveness is a function of objective sleep efficiency (SE) instead of objective sleep duration. This study is a secondary exploratory analysis of our earlier clinical trial to assess the differential therapeutic response to CBTi for older insomniacs based on SE prior to treatment. Method Seventy-nine adults (male=34, mean age=63.38, SD=6.25) with sleep maintenance insomnia were selected. Participants were grouped into 3 ordinal groups; the top 50% of participants (above the median percent sleep time-normal SE), the 25% of participants in the third quartile (moderately low SE), and the bottom 25% of participants (severely low SE) based on 1-night of home-based polysomnography. Participants were randomly allocated to CBTi or wait-list control. One-week sleep diaries, actigraphy and a battery of questionnaires evaluated the efficacy of CBTi for each SE group. Outcome measures were taken at pre-treatment, post-treatment, and 3-month follow-up. Results CBTi produced robust improvements in sleep quality including reduced wake after sleep onset, and improved sleep efficiency. Participants reported a reduction of scores on the Insomnia Severity Index, Flinders Fatigue Scale, Epworth Sleepiness Scale, Daytime Feeling and Functioning Scale, Sleep Anticipatory Anxiety Questionnaire, Dysfunctional Beliefs and Attitudes Scale, and increased Sleep Self-Efficacy Scale. All improvements were significant relative to waitlist and comparable regardless of objective SE at pre-treatment. Discussion CBTi responsiveness did not differ as a function of objective SE.

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Efficacy of Internet Delivered Cognitive Behaviour Therapy for Anxiety and Depression in People with Bipolar Disorder

10.21203/rs.3.rs-80609/v1 ◽

2020 ◽

Author(s):

Olav Nielssen ◽

Lauren Staples ◽

Eyal Karin ◽

Rony Kayrouz ◽

Blake Dear ◽

...

Keyword(s):

Bipolar Disorder ◽

Cognitive Behaviour Therapy ◽

Routine Care ◽

Anxiety And Depression ◽

Behaviour Therapy ◽

Research Reporting ◽

Cognitive Behaviour ◽

Assessment And Treatment ◽

Patient Health ◽

Psychiatric Conditions

Abstract BackgroundMindSpot is a national digital mental health service providing free assessment and treatment for anxiety and depression. Mindspot services have been accessed by people with a broad range of psychiatric conditions, including people who report a diagnosis of bipolar disorder (BD). There is comparatively little research reporting the outcome of internet delivered cognitive behaviour therapy (iCBT) for the depressed phase of BD (BDd), including as part of routine care. MethodDemographic characteristics, baseline scores and treatment outcomes were examined for patients who reported taking Lithium and had entries in their clinic records confirming the diagnosis of BD. Results were compared to the clinic benchmarks. Outcomes were completion rates, patient satisfaction and changes in measures of psychological distress, depression and anxiety as measured by the Kessler-10 item (K-10), Patient Health Questionnaire 9 Item (PHQ-9), and Generalized Anxiety Disorder Scale 7 Item (GAD-7), respectively. ResultsA total of 21,745 people completed a MindSpot assessment between January 2013 and December 2019 and enrolled in a MindSpot treatment course. Of these, 124 reported that they were currently taking Lithium, of whom 83 had entries in their clinic records confirming a diagnosis of BD. Mean age of patients with confirmed BD was 43.8 years, compared to the clinic mean of 39.8 years. Their baseline symptom scores were higher than the benchmark. However, reductions in symptoms on the K-10, PHQ-9, and GAD-7 were large (effect sizes > 1.0 on all measures, percentage change between 32.4% and 40%), and lesson completion and satisfaction with the course were also high. ConclusionsMindSpot treatments were effective in treating anxiety and depression in people diagnosed with BD, and the outcomes were comparable to clinic benchmarks. Results suggest that the routine provision of iCBT can help overcome the under-use of evidence based psychological treatments of people with BDd.

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