Effect of Sleep Disturbance Symptoms on Treatment Outcome in Blended Cognitive Behavioral Therapy for Depression (E-COMPARED Study): Secondary Analysis
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Otros documentos de la autoría: Jensen, Esben Kjems; Ladegaard, Nicolai; Mellentin, Angelina Isabella; Ebert, David Daniel; Titzler, Ingrid; Araya, Ricardo; Cerga Pashoja, Arlinda; Hazo, Jean-Baptiste; holtzmann, jerome; Cieslak, Roman; Smoktunowicz, Ewelina; Baños, Rosa Maria; Herrero, Rocío; García-Palacios, Azucena; Botella, Cristina; Berger, Thomas; Krieger, Tobias; Sainte-Marie, Trine Theresa Holmberg; Topooco, Naira; van Straten, Annemieke; Andersson, Gerhard; Kemmeren, Lise; Kleiboer, Annet; Riper, Heleen; Mathiasen, Kim
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Título
Effect of Sleep Disturbance Symptoms on Treatment Outcome in Blended Cognitive Behavioral Therapy for Depression (E-COMPARED Study): Secondary AnalysisAutoría
Fecha de publicación
2022Editor
JMIR PublicationsISSN
1438-8871Cita bibliográfica
Jensen ES, Ladegaard N, Mellentin AI, Ebert DD, Titzler I, Araya R, Cerga Pashoja A, Hazo J, Holtzmann J, Cieslak R, Smoktunowicz E, Baños R, Herrero R, García-Palacios A, Botella C, Berger T, Krieger T, Holmberg TT, Topooco N, Andersson G, van Straten A, Kemmeren L, Kleiboer A, Riper H, Mathiasen K Effect of Sleep Disturbance Symptoms on Treatment Outcome in Blended Cognitive Behavioral Therapy for Depression (E-COMPARED Study): Secondary Analysis J Med Internet Res 2022;24(3):e30231Tipo de documento
info:eu-repo/semantics/articleVersión
info:eu-repo/semantics/publishedVersionPalabras clave / Materias
Resumen
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 ... [+]
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. [-]
Publicado en
Journal of Medical Internet Research (JMIR) 2022;24(3):e30231Derechos de acceso
info:eu-repo/semantics/openAccess
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