Modified Cognitive Behavioral Therapy for Insomnia in Depressed Adolescents: A Pilot Study.
Objective/Background:The purpose of the study was to pilot a five-week insomnia treatment in adolescents with major depressive disorder (MDD) and insomnia. This was an open-label trial of a modified-group cognitive behavioral therapy for insomnia (CBTI).Participants:Adolescents with MDD (n= 16; mean age = 17.3 +/- 1.7), characterized by the Children's Depression Rating Scale-Revised T-score ≥ 55 and insomnia, characterized by > 30 min to fall or return to sleep and an Insomnia Severity Index (ISI) score of ≥ 7 participated.Methods:Sleep diaries, actigraphy, weekly ISI, Quick Inventory of Depressive Symptomatology (QIDS), and Multidimensional Fatigue Inventory (MFI) were completed.Results:Pairedt-tests comparing pre- and posttreatment revealed a decrease in sleep onset latency from 41 min +/- 14 min to 18 min +/- 8.9 min (t= 5.9,p= .004). Linear mixed modeling across sessions revealed that ISI (B= 11.0,SE= 0.94,p< .001), QIDS (B= 11.3,SE= 0.96,p< .001), and MFI (B= 30.0,SE= 4.4,p< .001) improved across treatment. Daily sleep diaries showed decreased wake during the night (B= 22.8,SE= 7.19,p= .008), increased sleep time (B= 382.4,SE= 71.89,p< .001), and increased quality of sleep (B= 3.7,SE= 0.37,p< .001). When asked whether group members would recommend this group, 27% responded "yes" and 73% responded "definitely yes."Conclusions:Additional controlled studies utilizing sleep-focused therapy in depressed adolescents with insomnia are warranted.
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.
Deirdre A
DA
Conroy
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.
Alison M
AM
Czopp
Pediatric Behavioral Development, University of Michigan, Ann Arbor, Michigan.
Dawn M
DM
Dore-Stites
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.
Richard R
RR
Dopp
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.
Roseanne
R
Armitage
Pediatric Sleep Medicine and Clinical Neurophysiology, University of Michigan, Ann Arbor, Michigan.
Timothy F
TF
Hoban
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.
J Todd
JT
Arnedt
D000293:Adolescent; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003865:Major Depressive Disorder / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D007319:Sleep Initiation and Maintenance Disorders / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome