Nan Bai, Juling Cao, Huiyue Zhang, Xin Liu, Min Yin
{"title":"针对失眠和抑郁症患者的数字认知行为疗法：系统回顾和荟萃分析。","authors":"Nan Bai, Juling Cao, Huiyue Zhang, Xin Liu, Min Yin","doi":"10.1111/jpm.13024","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> What is known on the subject</h3>\n \n <div>\n \n <ul>\n \n \n <li>Sleep problems are common among those with depression, and there is increasing evidence that sleep problems should be addressed during treatment simultaneously rather than treating depression alone.</li>\n \n \n <li>The first-line treatment for insomnia is cognitive behavioural therapy for insomnia (CBT-I), due to a lack of well-trained therapists and patient time constraints (travelling, work), CBT-I has not been popularized.</li>\n \n \n <li>The development of digital cognitive behavioural therapy for insomnia (dCBT-I) is making the treatment more accessible.</li>\n </ul>\n </div>\n </section>\n \n <section>\n \n <h3> What this paper adds to existing knowledge</h3>\n \n <div>\n \n <ul>\n \n \n <li>Interventions for dCBT-I were significantly better than other control conditions in both reducing insomnia and improving depression in patients with depression and insomnia comorbidities.</li>\n \n \n <li>The effect was found to be related to the duration of the intervention and the severity of insomnia before the intervention and therapist-involved dCBT-I has less shedding than self-help.</li>\n </ul>\n </div>\n </section>\n \n <section>\n \n <h3> What are the implications for practice</h3>\n \n <div>\n \n <ul>\n \n \n <li>It's important for mental health practitioners to realize that insomnia in depressed people needs to be treated.</li>\n \n \n <li>Future trials may explore the effectiveness of therapist-guided dCBT-I in depressed populations and analyse the cost-effectiveness of this treatment.</li>\n </ul>\n </div>\n </section>\n \n <section>\n \n \n <section>\n \n <h3>4.1 Aim</h3>\n \n <p>The aim of the study was to systematically identify and synthesize the evidence for the effectiveness of digital cognitive behavioural therapy in insomnia with comorbid depression.</p>\n </section>\n \n <section>\n \n <h3>4.2 Design</h3>\n \n <p>Systematic review and metaanalysis.</p>\n </section>\n \n <section>\n \n <h3>4.3 Methods</h3>\n \n <p>A search was conducted on five English and four non-English databases from the inception of the databases to November 2023. This review adhered to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-analysis Statement 2020 and the included studies were evaluated using version 2 of the Cochrane risk of bias tool. This review examined sleep-related outcomes, including insomnia severity and sleep diaries, along with psychological outcomes, such as depression. We conducted a meta-analysis of each outcome using a random effects model. Heterogeneity was assessed by the <i>I</i><sup>2</sup> statistic.</p>\n </section>\n \n <section>\n \n <h3>4.4 Results</h3>\n \n <p>A total of seven articles with 1864 participants were included in this review. The results showed that the digital cognitive behavioural therapy group demonstrated a statistically significant amelioration in the severity of insomnia symptoms, as well as a reduction in depressive symptomatology compared with the control groups. The post-intervention effect was found to be related to the duration of the intervention and the severity of insomnia before the intervention.</p>\n </section>\n \n <section>\n \n <h3>4.5 Conclusions</h3>\n \n <p>Digital cognitive behavioural therapy for insomnia application in patients with depression and insomnia was demonstrated to be effective, less time-consuming and more accessible.</p>\n </section>\n \n <section>\n \n <h3>4.6 Relevance to Clinical Practice</h3>\n \n <p>We may consider incorporating nurses into treatment plans and conducting nurse-led interventions in specific programs. In the future, nurses may be able to provide exclusive digital behavioural therapy for insomnia to patients with depression to achieve greater effectiveness.</p>\n </section>\n </section>\n </div>","PeriodicalId":50076,"journal":{"name":"Journal of Psychiatric and Mental Health Nursing","volume":null,"pages":null},"PeriodicalIF":2.6000,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Digital cognitive behavioural therapy for patients with insomnia and depression: A systematic review and meta-analysis\",\"authors\":\"Nan Bai, Juling Cao, Huiyue Zhang, Xin Liu, Min Yin\",\"doi\":\"10.1111/jpm.13024\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> What is known on the subject</h3>\\n \\n <div>\\n \\n <ul>\\n \\n \\n <li>Sleep problems are common among those with depression, and there is increasing evidence that sleep problems should be addressed during treatment simultaneously rather than treating depression alone.</li>\\n \\n \\n <li>The first-line treatment for insomnia is cognitive behavioural therapy for insomnia (CBT-I), due to a lack of well-trained therapists and patient time constraints (travelling, work), CBT-I has not been popularized.</li>\\n \\n \\n <li>The development of digital cognitive behavioural therapy for insomnia (dCBT-I) is making the treatment more accessible.</li>\\n </ul>\\n </div>\\n </section>\\n \\n <section>\\n \\n <h3> What this paper adds to existing knowledge</h3>\\n \\n <div>\\n \\n <ul>\\n \\n \\n <li>Interventions for dCBT-I were significantly better than other control conditions in both reducing insomnia and improving depression in patients with depression and insomnia comorbidities.</li>\\n \\n \\n <li>The effect was found to be related to the duration of the intervention and the severity of insomnia before the intervention and therapist-involved dCBT-I has less shedding than self-help.</li>\\n </ul>\\n </div>\\n </section>\\n \\n <section>\\n \\n <h3> What are the implications for practice</h3>\\n \\n <div>\\n \\n <ul>\\n \\n \\n <li>It's important for mental health practitioners to realize that insomnia in depressed people needs to be treated.</li>\\n \\n \\n <li>Future trials may explore the effectiveness of therapist-guided dCBT-I in depressed populations and analyse the cost-effectiveness of this treatment.</li>\\n </ul>\\n </div>\\n </section>\\n \\n <section>\\n \\n \\n <section>\\n \\n <h3>4.1 Aim</h3>\\n \\n <p>The aim of the study was to systematically identify and synthesize the evidence for the effectiveness of digital cognitive behavioural therapy in insomnia with comorbid depression.</p>\\n </section>\\n \\n <section>\\n \\n <h3>4.2 Design</h3>\\n \\n <p>Systematic review and metaanalysis.</p>\\n </section>\\n \\n <section>\\n \\n <h3>4.3 Methods</h3>\\n \\n <p>A search was conducted on five English and four non-English databases from the inception of the databases to November 2023. 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Digital cognitive behavioural therapy for patients with insomnia and depression: A systematic review and meta-analysis
What is known on the subject
Sleep problems are common among those with depression, and there is increasing evidence that sleep problems should be addressed during treatment simultaneously rather than treating depression alone.
The first-line treatment for insomnia is cognitive behavioural therapy for insomnia (CBT-I), due to a lack of well-trained therapists and patient time constraints (travelling, work), CBT-I has not been popularized.
The development of digital cognitive behavioural therapy for insomnia (dCBT-I) is making the treatment more accessible.
What this paper adds to existing knowledge
Interventions for dCBT-I were significantly better than other control conditions in both reducing insomnia and improving depression in patients with depression and insomnia comorbidities.
The effect was found to be related to the duration of the intervention and the severity of insomnia before the intervention and therapist-involved dCBT-I has less shedding than self-help.
What are the implications for practice
It's important for mental health practitioners to realize that insomnia in depressed people needs to be treated.
Future trials may explore the effectiveness of therapist-guided dCBT-I in depressed populations and analyse the cost-effectiveness of this treatment.
4.1 Aim
The aim of the study was to systematically identify and synthesize the evidence for the effectiveness of digital cognitive behavioural therapy in insomnia with comorbid depression.
4.2 Design
Systematic review and metaanalysis.
4.3 Methods
A search was conducted on five English and four non-English databases from the inception of the databases to November 2023. This review adhered to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-analysis Statement 2020 and the included studies were evaluated using version 2 of the Cochrane risk of bias tool. This review examined sleep-related outcomes, including insomnia severity and sleep diaries, along with psychological outcomes, such as depression. We conducted a meta-analysis of each outcome using a random effects model. Heterogeneity was assessed by the I2 statistic.
4.4 Results
A total of seven articles with 1864 participants were included in this review. The results showed that the digital cognitive behavioural therapy group demonstrated a statistically significant amelioration in the severity of insomnia symptoms, as well as a reduction in depressive symptomatology compared with the control groups. The post-intervention effect was found to be related to the duration of the intervention and the severity of insomnia before the intervention.
4.5 Conclusions
Digital cognitive behavioural therapy for insomnia application in patients with depression and insomnia was demonstrated to be effective, less time-consuming and more accessible.
4.6 Relevance to Clinical Practice
We may consider incorporating nurses into treatment plans and conducting nurse-led interventions in specific programs. In the future, nurses may be able to provide exclusive digital behavioural therapy for insomnia to patients with depression to achieve greater effectiveness.
期刊介绍：
The Journal of Psychiatric and Mental Health Nursing is an international journal which publishes research and scholarly papers that advance the development of policy, practice, research and education in all aspects of mental health nursing. We publish rigorously conducted research, literature reviews, essays and debates, and consumer practitioner narratives; all of which add new knowledge and advance practice globally.
All papers must have clear implications for mental health nursing either solely or part of multidisciplinary practice. Papers are welcomed which draw on single or multiple research and academic disciplines. We give space to practitioner and consumer perspectives and ensure research published in the journal can be understood by a wide audience. We encourage critical debate and exchange of ideas and therefore welcome letters to the editor and essays and debates in mental health.
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