Sleeping for two: A randomized controlled trial of cognitive behavioural therapy for insomnia (CBTI) delivered in pregnancy and secondary impacts on symptoms of postpartum depression.

Autor: Silang K; Department of Psychology, University of Calgary, Calgary, Canada. Electronic address: katherine.silang@ucalgary.ca., MacKinnon A; Department, of Psychiatry and Addictology, University of Montreal, Montreal, Canada., Madsen J; Department of Educational and Counselling Psychology, and Special Education, University of British Columbia, Vancouver, Canada., Giesbrecht GF; Department of Psychology, University of Calgary, Calgary, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Canada; Department of Pediatrics, University of Calgary, Calgary, Canada., Campbell T; School of Nursing, Faculty of Health and Social Development, University of British Columbia Okanagan campus, Kelowna, Canada; Faculty of Nursing, University of Calgary, Calgary, Canada., Keys E; School of Nursing, Faculty of Health and Social Development, University of British Columbia Okanagan campus, Kelowna, Canada; Faculty of Nursing, University of Calgary, Calgary, Canada., Freeman M; Department of Educational and Counselling Psychology, and Special Education, University of British Columbia, Vancouver, Canada., Dewsnap K; Department of Educational and Counselling Psychology, and Special Education, University of British Columbia, Vancouver, Canada., Jung JW; Department of Psychology, University of Calgary, Calgary, Canada., Tomfohr-Madsen LM; Department of Educational and Counselling Psychology, and Special Education, University of British Columbia, Vancouver, Canada.
Jazyk: angličtina
Zdroj: Journal of affective disorders [J Affect Disord] 2024 Oct 01; Vol. 362, pp. 670-678. Date of Electronic Publication: 2024 Jul 18.
DOI: 10.1016/j.jad.2024.07.117
Abstrakt: Background: Insomnia in pregnancy is common and highly comorbid with depression.
Objective: To investigate if: 1) depressive symptoms decrease after cognitive behavioural therapy for insomnia (CBTI) delivered in pregnancy, and 2) changes in insomnia symptoms represent a mechanism linking CBT-I treatment and reduced symptoms of postpartum depression.
Methods: A two-arm, single-blind, parallel groups randomized controlled trial (RCT) design was used to evaluate the impact of a 5-week CBT-I intervention adapted for pregnant people with insomnia (N = 62). Participants were eligible if they were pregnant, between 12 and 28 weeks gestation, and met diagnostic criteria for insomnia. Participants completed questionnaires assessing symptoms of insomnia and depression pre-intervention (T1), post-intervention (T2), and six months postpartum (T3). A path analysis model was used to test direct and indirect effects simultaneously.
Results: There was a significant direct effect of CBT-I on postpartum depressive symptoms at T3. Additionally, significant indirect treatment effects on depressive symptoms at T3 emerged, through depressive symptoms at T2 and through improvements in insomnia that persisted from T2 to T3.
Limitations: Limitations to the current study include limited generalizability, the non-depressed sample, and variability in treatment and assessment delivery (in-person vs. online).
Conclusions: CBT-I treatment in pregnancy may indirectly reduce postpartum depressive symptoms, through sustained improvements in insomnia symptoms.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Crown Copyright © 2024. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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