title: Do Sleep Disturbances Predict or Moderate the Response to Psychotherapy in Bipolar Disorder?
abstract: This study examined whether sleep disturbance predicted or moderated responses to psychotherapy in participants who participated in STEP-BD, a national, multisite study that examined the effectiveness of different treatment combinations for bipolar disorder. Participants received either a brief psychosocial intervention called collaborative care (CC; n = 130) or intensive psychotherapy (IP; n = 163), with study-based pharmacotherapy. Participants (N = 243) were defined as current (past week) short sleepers (<6 hours/night), normal sleepers (6.5-8.5 hours/night), and long sleepers (≥9 hours/night), according to reported average nightly sleep duration the week before randomization. Sleep disturbances did not predict the likelihood of recovery nor time until recovery from a depressive episode. There was no difference in recovery rates between IP versus CC for normal sleepers, and medium effect sizes were observed for differences in short and long sleepers. In this study, sleep did not play a major role in predicting or moderating response to psychotherapy in bipolar disorder.
authors.affiliation: *Massachusetts General Hospital and †Harvard Medical School, Boston, MA; ‡Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, NC; §Department of Psychology, University of Illinois at Chicago, Chicago, IL; ∥National Institute for Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; ¶Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA; #UCLA School of Medicine, Los Angeles, CA; **Department of Psychological & Brain Sciences, Boston University, Boston, MA; ††Department of Psychiatry, Deakin University, Victoria; and ‡‡Department of Psychiatry, University of Melbourne, Melbourne, Australia.
authors.forename: Louisa G
authors.initials: LG
authors.lastname: Sylvia
authors.forename: Stephanie
authors.initials: S
authors.lastname: Salcedo
authors.forename: Amy T
authors.initials: AT
authors.lastname: Peters
authors.forename: Pedro Vieira da Silva
authors.initials: PV
authors.lastname: Magalhães
authors.forename: Ellen
authors.initials: E
authors.lastname: Frank
authors.forename: David J
authors.initials: DJ
authors.lastname: Miklowitz
authors.forename: Michael W
authors.initials: MW
authors.lastname: Otto
authors.forename: Michael
authors.initials: M
authors.lastname: Berk
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Nierenberg
authors.forename: Thilo
authors.initials: T
authors.lastname: Deckersbach
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000453:epidemiology / Q000628:therapy*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011613:Psychotherapy / Q000379:methods*; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000503:physiopathology*