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Cited by 133Sleep and related disordersAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychotherapy Techniques and Applications

Brief Behavioral Therapy for Refractory Insomnia in Residual Depression: An Assessor-Blind, Randomized Controlled Trial

Watanabe, Norio, Furukawa, Toshi A., Shimodera, Shinji, Morokuma, Ippei, Katsuki, Fujika, Fujita, Hirokazu, Sasaki, Megumi, Kawamura, Chihiro +1 more·2011·The Journal of Clinical Psychiatry
DOI 10.4088/jcp.10m06130gry
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Abstract

OBJECTIVE: Insomnia often persists despite pharmacotherapy in depression and represents an obstacle to its full remission. This study aimed to investigate the added value of brief behavioral therapy for insomnia over treatment as usual (TAU) for residual depression and refractory insomnia. METHOD: Thirty-seven outpatients (mean age of 50.5 years) were randomly assigned to TAU alone or TAU plus brief behavioral therapy for insomnia, consisting of 4 weekly 1-hour individual sessions. The Insomnia Severity Index (ISI) scores (primary outcome), sleep parameters, and GRID-Hamilton Depression Rating Scale (GRID-HAMD) scores were assessed by blind raters and remission rates for both insomnia and depression were collected at 4- and 8-week follow-ups. The patients were recruited from February 18, 2008, to April 9, 2009. RESULTS: Brief behavioral therapy for insomnia plus TAU resulted in significantly lower ISI scores than TAU alone at 8 weeks (P < .0005). The sleep efficiency for the combination was also significantly better than that for TAU alone (P = .015). Significant differences were observed in favor of the combination group on both the total GRID-HAMD scores (P = .013) and the GRID-HAMD scores after removing the 3 sleep items (P = .008). The combination treatment produced higher rates of remission than TAU alone, both in terms of insomnia (50% vs 0%), with a number needed to treat (NNT) of 2 (95% CI, 1-4), and in terms of depression (50% vs 6%), with an NNT of 2 (95% CI, 1-5). CONCLUSIONS: In patients with residual depression and treatment refractory insomnia, adding brief behavioral therapy for insomnia to usual clinical care produced statistically significant and clinically substantive added benefits. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00610259.

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  • Simple signposting services-assessment of needs to help identify opportunities for participation in local social activities, based in primary care or community facilities-are both effective and cost-effective in reducing social isolation and loneliness.

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    From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [467]

  • The severity of affective experiences is reduced when sleep is improved through intervention.

    “There is also evidence that the severity of affective experiences is reduced when sleep is improved through intervention [29–33].”

    From A structural equation model of the relationship between insomnia, negative affect, and paranoid thinking (2017) · cites this paper as [33]

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Authors
Watanabe, N., Furukawa, T. A., Shimodera, S., Morokuma, I., Katsuki, F., Fujita, H., Sasaki, M., Kawamura, C., & Perlis, M. L.
Affiliations
  • Nagoya City University (JP)
  • Kōchi University (JP)
  • Naruto University of Education (JP)
  • University of Pennsylvania (US)
Corresponding author
Watanabe, Norio
ORCID
Venue
The Journal of Clinical Psychiatry
Publisher
Physicians Postgraduate Press, Inc
Published
2011-03-08
Volume
72
Issue
12
Pages
1651-1658
ISSN
0160-6689 (ISSN-L)
DOI
10.4088/jcp.10m06130gry
OpenAlex
W2062451848
Cited by
132
References
0
Citations by year
2026: 5 · 2025: 4 · 2024: 8 · 2023: 10 · 2022: 9 · 2021: 6 · 2020: 9 · 2019: 9 · 2018: 12 · 2017: 12 · 2016: 6 · 2015: 17 · 2014: 9 · 2013: 5 · 2012: 6
FWCI
9.92
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
Japan Society for the Promotion of Science (22590596)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
insomnia, residual depression, cognitive behavioral therapy, depression remission, sleep efficiency, Insomnia Severity Index, adjunctive therapy
MeSH terms
Adult, Antidepressive Agents, Behavior Therapy, Combined Modality Therapy, Female, Humans, Hypnotics and Sedatives, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Psychiatric Status Rating Scales, Severity of Illness Index, Time Factors, Single-Blind Method, Treatment Outcome, Depressive Disorder, Treatment-Resistant

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