title: Effects of cognitive behavioral therapy in patients with depressive disorder and comorbid insomnia: A propensity score-matched outcome study.
abstract: OBJECTIVE
  We evaluated the effects of cognitive behavioral therapy for insomnia (CBT-I) in inpatients with a diagnosis of depression and comorbid insomnia.
  
  
  METHODS
  This study used a prospective, parallel-group design. The experimental group received CBT-I for no more than 90 min once weekly for 6 weeks and the control group only have health education manuals for insomnia. The following questionnaires were administered at baseline: the Hamilton Rating Scale for Depression (HAM-D), Dysfunctional Beliefs and Attitudes about Sleep (DBAS), Presleep Arousal Scale (PSAS), Sleep Hygiene Practice (SHP), and Pittsburgh Sleep Quality Index. The questionnaires were readministered after the completion of the 6-wk CBT-I intervention and 1 month following the completion of CBT-I, to determine the effects of the CBT-I intervention over time. The analysis of Generalized Estimation Equations was identified the difference between the experimental group and the control group by controlling for the variables in BZD dose and propensity score of gender, age, and the scores for the DBAS-16, PSAS, SHPS, and HAM-D.
  
  
  RESULTS
  Consequently, the significant difference in the PSQI scores was observed at the 1-month follow-up assessment however, no significant intergroup difference in the PSQI scores was found at the completion of the CBT-I intervention between two groups.
  
  
  CONCLUSIONS
  As a conclusion, we found that overall sleep quality significantly improved in patients who received CBT-I after we controlled for the BZD dose and propensity score, which suggests that CBT-I may represent a useful clinical strategy for improving sleep quality in patients with depression and comorbid insomnia.
authors: Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.
authors: Hui-Min
authors: HM
authors: Hsu
authors: School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan; Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Department of Nursing, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan; Graduate Institutes of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
authors: Kuei-Ru
authors: KR
authors: Chou
authors: Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
authors: Kuan-Chia
authors: KC
authors: Lin
authors: Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.
authors: Kuan-Yu
authors: KY
authors: Chen
authors: Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan; Institution of Nursing and Health Science, National Taipei University, Taipei, Taiwan.
authors: Shu-Fang
authors: SF
authors: Su
authors: Graduate Institutes of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan. Electronic address: minhuey300@tmu.edu.tw.
authors: Min-Huey
authors: MH
authors: Chung
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015897:Comorbidity; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D007319:Sleep Initiation and Maintenance Disorders / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome
keywords: Cognitive behavioral therapy; Depressive disorder; Insomnia; Sleep hygiene; Sleep quality