Effect of Sleep Disturbance Symptoms on Treatment Outcome in Blended Cognitive Behavioral Therapy for Depression (E-COMPARED Study): Secondary Analysis.

Autor: Jensen ES; Centre for Telepsychiatry, Mental Health Services of Southern Denmark, Odense, Denmark.; Department of Clinical Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark., Ladegaard N; Department of Affective Disorders, Aarhus University Hospital, Aarhus, Denmark., Mellentin AI; Centre for Telepsychiatry, Mental Health Services of Southern Denmark, Odense, Denmark.; Department of Clinical Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.; Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Brain Research-Inter-Disciplinary Guided Excellence (BRIDGE), Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Ebert DD; Department for Sport and Health Sciences, Chair for Psychology & Digital Mental Health Care, Technical University Munich, Munich, Germany., Titzler I; Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany., Araya R; Centre for Global Mental Health, King's College London, London, United Kingdom., Cerga Pashoja A; Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.; Global Public Health, Public Health England, London, United Kingdom., Hazo JB; URC Eco Ile-de-France (AP-HP), Hotel Dieu, Paris, France.; Assistance Publique-Hôpitaux de Paris, Health Economics Research Unit, University of Paris, Paris, France., Holtzmann J; Fondation FondaMental, Créteil, France.; Service de Psychiatrie de l'adulte, Centre Expert Dépression Résistante FondaMental, Grenoble University Hospital, Grenoble, France., Cieslak R; Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland.; Lyda Hill Institute for Human Resilience, University of Colorado, Colorado Springs, CO, United States., Smoktunowicz E; Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland., Baños R; Instituto Polibienestar, University of Valencia, Valencia, Spain.; CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain., Herrero R; Instituto Polibienestar, University of Valencia, Valencia, Spain.; CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain., García-Palacios A; CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain.; Department of Basic Psychology, Clinic and Psychobiology, University Jaume I, Castellón, Spain., Botella C; CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain.; Department of Basic Psychology, Clinic and Psychobiology, University Jaume I, Castellón, Spain., Berger T; Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland., Krieger T; Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland., Holmberg TT; Centre for Telepsychiatry, Mental Health Services of Southern Denmark, Odense, Denmark.; Department of Clinical Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark., Topooco N; Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.; Center for m2Health, Palo Alto University, Palo Alto, CA, United States., Andersson G; Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.; Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden., van Straten A; Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands.; Amsterdam Public Health Research Institute, Amsterdam, Netherlands., Kemmeren L; Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands., Kleiboer A; Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands., Riper H; Centre for Telepsychiatry, Mental Health Services of Southern Denmark, Odense, Denmark.; Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands., Mathiasen K; Centre for Telepsychiatry, Mental Health Services of Southern Denmark, Odense, Denmark.; Department of Clinical Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.; Department of Affective Disorders, Aarhus University Hospital, Aarhus, Denmark.
Jazyk: angličtina
Zdroj: Journal of medical Internet research [J Med Internet Res] 2022 Mar 21; Vol. 24 (3), pp. e30231. Date of Electronic Publication: 2022 Mar 21.
DOI: 10.2196/30231
Abstrakt: Background: Sleep disturbance symptoms are common in major depressive disorder (MDD) and have been found to hamper the treatment effect of conventional face-to-face psychological treatments such as cognitive behavioral therapy. To increase the dissemination of evidence-based treatment, blended cognitive behavioral therapy (bCBT) consisting of web-based and face-to-face treatment is on the rise for patients with MDD. To date, no study has examined whether sleep disturbance symptoms have an impact on bCBT treatment outcomes and whether it affects bCBT and treatment-as-usual (TAU) equally.
Objective: The objectives of this study are to investigate whether baseline sleep disturbance symptoms have an impact on treatment outcomes independent of treatment modality and whether sleep disturbance symptoms impact bCBT and TAU in routine care equally.
Methods: The study was based on data from the E-COMPARED (European Comparative Effectiveness Research on Blended Depression Treatment Versus Treatment-as-Usual) study, a 2-arm, multisite, parallel randomized controlled, noninferiority trial. A total of 943 outpatients with MDD were randomized to either bCBT (476/943, 50.5%) or TAU consisting of routine clinical MDD treatment (467/943, 49.5%). The primary outcome of this study was the change in depression symptom severity at the 12-month follow-up. The secondary outcomes were the change in depression symptom severity at the 3- and 6-month follow-up and MDD diagnoses at the 12-month follow-up, assessed using the Patient Health Questionnaire-9 and Mini-International Neuropsychiatric Interview, respectively. Mixed effects models were used to examine the association of sleep disturbance symptoms with treatment outcome and treatment modality over time.
Results: Of the 943 patients recruited for the study, 558 (59.2%) completed the 12-month follow-up assessment. In the total sample, baseline sleep disturbance symptoms did not significantly affect change in depressive symptom severity at the 12-month follow-up (β=.16, 95% CI -0.04 to 0.36). However, baseline sleep disturbance symptoms were negatively associated with treatment outcome for bCBT (β=.49, 95% CI 0.22-0.76) but not for TAU (β=-.23, 95% CI -0.50 to 0.05) at the 12-month follow-up, even when adjusting for baseline depression symptom severity. The same result was seen for the effect of sleep disturbance symptoms on the presence of depression measured with Mini-International Neuropsychiatric Interview at the 12-month follow-up. However, for both treatment formats, baseline sleep disturbance symptoms were not associated with depression symptom severity at either the 3- (β=.06, 95% CI -0.11 to 0.23) or 6-month (β=.09, 95% CI -0.10 to 0.28) follow-up.
Conclusions: Baseline sleep disturbance symptoms may have a negative impact on long-term treatment outcomes in bCBT for MDD. This effect was not observed for TAU. These findings suggest that special attention to sleep disturbance symptoms might be warranted when MDD is treated with bCBT. Future studies should investigate the effect of implementing modules specifically targeting sleep disturbance symptoms in bCBT for MDD to improve long-term prognosis.
(©Esben Skov Jensen, Nicolai Ladegaard, Angelina Isabella Mellentin, David Daniel Ebert, Ingrid Titzler, Ricardo Araya, Arlinda Cerga Pashoja, Jean-Baptiste Hazo, Jérôme Holtzmann, Roman Cieslak, Ewelina Smoktunowicz, Rosa Baños, Rocio Herrero, Azucena García-Palacios, Cristina Botella, Thomas Berger, Tobias Krieger, Trine Theresa Holmberg, Naira Topooco, Gerhard Andersson, Annemieke van Straten, Lise Kemmeren, Annet Kleiboer, Heleen Riper, Kim Mathiasen. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 21.03.2022.)
Databáze: MEDLINE
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