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Cognitive Behaviour...
Cognitive Behavioural Therapy for Nightmares for Patients with Persecutory Delusions (Nites) : An Assessor-Blind, Pilot Randomized Controlled Trial
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- Sheaves, Bryony (author)
- Univ Oxford, Warneford Hosp, Dept Psychiat, Oxford, England;Oxford Hlth NHS Fdn Trust, Warneford Hosp, Oxford OX3 7JX, England
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- Holmes, Emily A. (author)
- Karolinska Institutet,Uppsala universitet,Institutionen för psykologi,Univ Oxford, Warneford Hosp, Dept Psychiat, Oxford, England;Karolinska Inst, Dept Clin Neurosci, Div Psychol, Solna, Sweden
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- Rek, Stephanie (author)
- Univ Oxford, Warneford Hosp, Dept Psychiat, Oxford, England
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- Taylor, Kathryn M. (author)
- Univ Oxford, Warneford Hosp, Dept Psychiat, Oxford, England
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- Nickless, Alecia (author)
- Univ Oxford, Nuffield Dept Primary Care Hlth Sci, Radcliffe Observ Quarter, Primary Care Clin Trials Unit, Oxford, England
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- Waite, Felicity (author)
- Univ Oxford, Warneford Hosp, Dept Psychiat, Oxford, England;Oxford Hlth NHS Fdn Trust, Warneford Hosp, Oxford OX3 7JX, England
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- Germain, Anne (author)
- Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA USA
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- Espie, Colin A. (author)
- Univ Oxford, Nuffield Dept Clin Neurosci, Oxford, England
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- Harrison, Paul J. (author)
- Univ Oxford, Warneford Hosp, Dept Psychiat, Oxford, England;Oxford Hlth NHS Fdn Trust, Warneford Hosp, Oxford OX3 7JX, England
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- Foster, Russell (author)
- Univ Oxford, Nuffield Dept Clin Neurosci, Oxford, England
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- Freeman, Daniel (author)
- Univ Oxford, Warneford Hosp, Dept Psychiat, Oxford, England;Oxford Hlth NHS Fdn Trust, Warneford Hosp, Oxford OX3 7JX, England
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(creator_code:org_t)
- 2019-05-26
- 2019
- English.
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In: Canadian journal of psychiatry. - : SAGE Publications. - 0706-7437 .- 1497-0015. ; 64:10, s. 686-696
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Abstract
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- Objective:Nightmares are relatively common in patients experiencing psychosis but rarely assessed or treated. Nightmares may maintain persecutory delusions by portraying fears in sensory-rich detail. We tested the potential benefits of imagery-focused cognitive behavioural therapy (CBT) for nightmares on nightmare severity and persecutory delusions.Method: This assessor-blind parallel-group pilot trial randomized 24 participants with nightmares and persecutory delusions to receive CBT for nightmares delivered over 4 weeks in addition to treatment as usual (TAU) or TAU alone. Assessments were at 0, 4 (end of treatment), and 8 weeks (follow-up). Feasibility outcomes assessed therapy uptake, techniques used, satisfaction, and attrition. The primary efficacy outcome assessed nightmare severity at week 4. Analyses were intention to treat, estimating treatment effect with 95% confidence intervals (CIs).Results:All participants offered CBT completed therapy (mean [SD], 4.8 [0.6] sessions) with high satisfaction, and 20 (83%) participants completed all assessments. Compared with TAU, CBT led to large improvements in nightmares (adjusted mean difference = -7.0; 95% CI, -12.6 to -1.3; d = -1.1) and insomnia (6.3; 95% CI, 2.6 to 10.0; d = 1.4) at week 4. Gains were maintained at follow-up. Suicidal ideation was not exacerbated by CBT but remained stable to follow-up, compared with TAU, which reduced at follow-up (6.8; 95% CI, 0.3 to 3.3; d = 0.7). CBT led to reductions in paranoia (-20.8; 95% CI, -43.2 to 1.7; d = -0.6), although CIs were wide. Three serious adverse events were deemed unrelated to participation (CBT = 2, TAU = 1).Conclusions:CBT for nightmares is feasible and may be efficacious for treating nightmares and comorbid insomnia for patients with persecutory delusions. It shows promise on paranoia but potentially not on suicidal ideation.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Psykiatri (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Psychiatry (hsv//eng)
Keyword
- nightmares
- psychosis
- paranoia
- sleep
- schizophrenia
- mental imagery
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Sheaves, Bryony
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Holmes, Emily A.
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Rek, Stephanie
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Taylor, Kathryn ...
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Nickless, Alecia
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Waite, Felicity
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show more...
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Germain, Anne
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Espie, Colin A.
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Harrison, Paul J ...
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Foster, Russell
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Freeman, Daniel
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Psychiatry
- Articles in the publication
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Canadian journal ...
- By the university
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Uppsala University
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Karolinska Institutet