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This 12-week study with a six-month follow-up aimed to ascertain whether combining Cognitive Behavioral Therapy for Insomnia (CBT-I) with Cognitive Behavioral Therapy for Depression (CBT-D), without extending treatment duration, results in greater reductions in both insomnia and depression compared to CBT-D with a placebo insomnia intervention.
CBT-I is recommended as the primary treatment for people with both depression and insomnia. Adding psychological depression treatment alongside CBT-I may not be helpful and could be burdensome.
This 12-week study with a six-month follow-up aimed to ascertain whether combining Cognitive Behavioral Therapy for Insomnia (CBT-I) with Cognitive Behavioral Therapy for Depression (CBT-D), without extending treatment duration, results in greater reductions in both insomnia and depression compared to CBT-D with a placebo insomnia intervention.
Employing therapist-guided internet-delivered treatments, this study was carried out in a psychiatric unit. A total of 126 volunteers were detected with major depression and insomnia disorder by physicians. The enrolled subjects were segregated into two groups:
The key outcome measures were self-rating scales: the Insomnia Severity Index (ISI) and the Montgomery-Åsberg Depression Rating Scale (MADRS-S).
When compared to the control group, the combined treatment group demonstrated specific effects on insomnia severity (p = 0.007) but did not exhibit greater efficacy in minimizing the severity of depression. In this double-blind, randomized controlled trial, the within-group effect sizes (Cohen's d) at post-treatment and at six months were: MADRS-S 0.97 and 1.12 (combined), 0.88 and 0.89 (control); ISI 1.40 and 1.42 (combined treatment), 0.95 and 1.00 (control).
It was recommended that CBT-I must be prioritized for patients with comorbid insomnia and depression, possibly as the primary treatment choice. The addition of a psychological depression treatment alongside CBT-I might be overly burdensome and may not confer additional benefits.
CBT-I yielded significant specific effects on insomnia severity and outperformed the control intervention in this aspect. However, both treatments showed similar effects on depression severity, indicating that combining CBT-I with CBT-D did not lead to improved depression outcomes when compared to the control intervention.
Psychotherapy and Psychosomatics
Psychological Treatment of Comorbid Insomnia and Depression: A Double-Blind Randomized Placebo-Controlled Trial
Blom K et al.
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