title: Group cognitive behavioural therapy for insomnia: Effects on sleep and depressive symptomatology in a sample with comorbidity.
abstract: OBJECTIVE
  To investigate the effects of group CBT for insomnia (CBT-I) on insomnia and depressive symptomatology in a comorbid sample through a randomised controlled trial with a 6 month follow-up.
  
  
  METHODS
  64 participants were recruited through advertisements and randomised to receive CBT-I or an active control (relaxation training: RT) during four group sessions. Insomnia Severity Index and BDI-II were the primary outcome measures, assessed pre-treatment, post-treatment and at 6 month follow-up. Insomnia and depressive diagnoses, and functional impairment were assessed before and after treatment, whereas sleep diary data was gathered continuously from one week before treatment until after treatment.
  
  
  RESULTS
  CBT-I was more efficient than RT in reducing insomnia severity and equally effective in reducing depressive symptoms, although CBT-I was associated with a higher proportion of remitted persons than RT, regarding both insomnia and depression diagnoses. Also, CBT-I was associated with less functional impairment, shorter sleep onset latency and wake after sleep onset but both treatments had equal improvements of sleep quality, early morning awakenings and total sleep time.
  
  
  CONCLUSIONS
  Group CBT-I is an efficient form of insomnia-treatment for people with insomnia comorbid with depressive symptomatology. The mixed results regarding depression outcomes warrants replication and further studies into treatment mechanisms.
authors.affiliation: Centre for Research on Child and Adolescent Mental Health, Karlstad University, SE-651 88 Karlstad, Sweden. Electronic address: annika.clarke@kau.se.
authors.forename: Annika
authors.initials: A
authors.lastname: Norell-Clarke
authors.affiliation: School of Law, Psychology, and Social Work, Örebro University, SE-701 82 Örebro, Sweden; Department of Psychology, Stockholm University, SE-106 91 Stockholm, Sweden.
authors.forename: Markus
authors.initials: M
authors.lastname: Jansson-Fröjmark
authors.affiliation: School of Law, Psychology, and Social Work, Örebro University, SE-701 82 Örebro, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Tillfors
authors.affiliation: School of Health and Medical Sciences, Örebro University, SE-70182 Örebro, Sweden; University Health Care Research Centre, Box 1613, S-701 16, Örebro, Sweden.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Holländare
authors.affiliation: School of Health and Medical Sciences, Örebro University, SE-70182 Örebro, Sweden; University Health Care Research Centre, Box 1613, S-701 16, Örebro, Sweden.
authors.forename: Ingemar
authors.initials: I
authors.lastname: Engström
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015897:Comorbidity; D003863:Depression / Q000523:psychology / Q000628:therapy*; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011615:Psychotherapy, Group / Q000379:methods*; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Co-morbidity; Cognitive behavioural therapy; Depression; Insomnia; RCT; Relaxation