以小组为基础的跨诊断睡眠和昼夜节律治疗重度抑郁障碍:随机对照试验。

IF 4.5 1区 心理学 Q1 PSYCHOLOGY, CLINICAL Journal of consulting and clinical psychology Pub Date : 2024-03-01 Epub Date: 2024-01-25 DOI:10.1037/ccp0000869
Anneko Yuen-Yum Yau, Ka-Yan Ng, Wing-Yin Lau, Chun-Yin Poon, Wing-Fai Yeung, Ka-Fai Chung, Christian S Chan, Allison G Harvey, Fiona Yan-Yee Ho
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引用次数: 0

摘要

目的:睡眠和昼夜节律紊乱是一系列心理疾病,尤其是重度抑郁症(MDD)的高合并症。鉴于睡眠和昼夜节律问题在重度抑郁症中的复杂性,本研究旨在评估以小组为基础的睡眠和昼夜节律功能障碍跨诊断干预(TranS-C)对改善抑郁症状、睡眠和昼夜节律功能的疗效:将152名被诊断为合并有MDD和睡眠与昼夜节律失调的成年人随机分为TranS-C小组治疗组(TranS-C;n = 77)或常规护理对照组(CAU;n = 75)。TranS-C小组每周接受六次2小时的TranS-C小组治疗,而CAU小组则继续接受常规护理。评估时间为基线、治疗后即刻(第 7 周)和 12 周(第 19 周)。主要和次要结果包括抑郁、焦虑、睡眠障碍、疲劳、生活质量和功能障碍:结果:TranS-C 治疗组在抑郁症状(p < .001,d = 0.84)、失眠严重程度(p < .001,d = 0.77)、睡眠障碍(p < .001,d = 1.15)、睡眠相关损伤(p < .001,d = 1.22)、疲劳(p < .001,d = 1.06)、焦虑症状(p = .004,d = 0.67)、生活质量(p < .001,d = 0.71)和睡眠日记衍生参数(ps < .05,d = 0.12-0.77)。在 12 周的随访中,这些治疗效果依然显著。随访12周时,功能障碍也有明显改善:结论:TranS-C在缓解抑郁症状、睡眠和昼夜节律紊乱方面对患有MDD的成年人有效且可接受。小组形式似乎是提供 TranS-C 的一种低成本、可广泛传播的选择。我们有必要对 TranS-C 进行进一步研究,探讨它对其他精神疾病的益处。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
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A group-based transdiagnostic sleep and circadian treatment for major depressive disorder: A randomized controlled trial.

Objective: Sleep and circadian disturbance is highly comorbid with a range of psychological disorders, especially major depressive disorder (MDD). In view of the complexity of sleep and circadian problems in MDD, this study aimed to evaluate the efficacy of a group-based transdiagnostic intervention for sleep and circadian dysfunction (TranS-C) for improving depressive symptoms and sleep and circadian functions.

Method: One hundred fifty-two adults diagnosed with comorbid MDD and sleep and circadian dysfunctions were randomized into TranS-C group treatment (TranS-C; n = 77) or care as usual (CAU; n = 75) control group. The TranS-C group received six weekly 2-hr group sessions of TranS-C, whereas the CAU group continued to receive usual care. Assessments were at baseline, immediate (Week 7), and 12-week (Week 19) posttreatment. Primary and secondary outcomes included depression, anxiety, sleep disturbances, fatigue, quality of life, and functional impairment.

Results: The TranS-C group showed significant improvement in depressive symptoms (p < .001, d = 0.84), insomnia severity (p < .001, d = 0.77), sleep disturbances (p < .001, d = 1.15), sleep-related impairment (p < .001, d = 1.22), fatigue (p < .001, d = 1.06), anxiety symptoms (p = .004, d = 0.67), quality of life (p < .001, d = 0.71), and sleep diary-derived parameters (ps < .05, d = 0.12-0.77) relative to the CAU group at immediate posttreatment. These treatment gains remained significant at 12-week follow-up. Significant improvement in functional impairment was also noted at 12-week follow-up.

Conclusions: TranS-C was efficacious and acceptable in alleviating depressive symptoms and sleep and circadian disruptions in adults with MDD. The group format appears to be a low-cost, widely disseminable option to deliver TranS-C. Further research on TranS-C to examine its benefits on other psychiatric disorders is warranted. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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期刊介绍: The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.
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