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  • Jensen, Esben SkovMental Hlth Serv Southern Denmark, Denmark; Univ Southern Denmark, Denmark (author)

Effect of Sleep Disturbance Symptoms on Treatment Outcome in Blended Cognitive Behavioral Therapy for Depression (E-COMPARED Study): Secondary Analysis

  • Article/chapterEnglish2022

Publisher, publication year, extent ...

  • 2022-03-21
  • JMIR Publications Inc,2022
  • electronicrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:liu-185046
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-185046URI
  • https://doi.org/10.2196/30231DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:149421547URI

Supplementary language notes

  • Language:English
  • Summary in:English

Part of subdatabase

Classification

  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Funding Agencies|Innovation Fund Denmark
  • Background: Sleep disturbance symptoms are common in major depressive disorder (MDD) and have been found to hamper the treatment effect of conventional face-to-face psychological treatments such as cognitive behavioral therapy. To increase the dissemination of evidence-based treatment, blended cognitive behavioral therapy (bCBT) consisting of web-based and face-to-face treatment is on the rise for patients with MDD. To date, no study has examined whether sleep disturbance symptoms have an impact on bCBT treatment outcomes and whether it affects bCBT and treatment-as-usual (TAU) equally. Objective: The objectives of this study are to investigate whether baseline sleep disturbance symptoms have an impact on treatment outcomes independent of treatment modality and whether sleep disturbance symptoms impact bCBT and TAU in routine care equally. Methods: The study was based on data from the E-COMPARED (European Comparative Effectiveness Research on Blended Depression Treatment Versus Treatment-as-Usual) study, a 2-arm, multisite, parallel randomized controlled, noninferiority trial. A total of 943 outpatients with MDD were randomized to either bCBT (476/943, 50.5%) or TAU consisting of routine clinical MDD treatment (467/943, 49.5%). The primary outcome of this study was the change in depression symptom severity at the 12-month follow-up. The secondary outcomes were the change in depression symptom severity at the 3- and 6-month follow-up and MDD diagnoses at the 12-month follow-up, assessed using the Patient Health Questionnaire-9 and Mini-International Neuropsychiatric Interview, respectively. Mixed effects models were used to examine the association of sleep disturbance symptoms with treatment outcome and treatment modality over time. Results: Of the 943 patients recruited for the study, 558 (59.2%) completed the 12-month follow-up assessment. In the total sample, baseline sleep disturbance symptoms did not significantly affect change in depressive symptom severity at the 12-month follow-up (beta=.16, 95% CI -0.04 to 0.36). However, baseline sleep disturbance symptoms were negatively associated with treatment outcome for bCBT (beta=.49, 95% CI 0.22-0.76) but not for TAU (beta=-.23, 95% CI -0.50 to 0.05) at the 12-month follow-up, even when adjusting for baseline depression symptom severity. The same result was seen for the effect of sleep disturbance symptoms on the presence of depression measured with Mini-International Neuropsychiatric Interview at the 12-month follow-up. However, for both treatment formats, baseline sleep disturbance symptoms were not associated with depression symptom severity at either the 3- (beta=.06, 95% CI -0.11 to 0.23) or 6-month (beta=.09, 95% CI -0.10 to 0.28) follow-up. Conclusions: Baseline sleep disturbance symptoms may have a negative impact on long-term treatment outcomes in bCBT for MDD. This effect was not observed for TAU. These findings suggest that special attention to sleep disturbance symptoms might be warranted when MDD is treated with bCBT. Future studies should investigate the effect of implementing modules specifically targeting sleep disturbance symptoms in bCBT for MDD to improve long-term prognosis.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Ladegaard, NicolaiAarhus Univ Hosp, Denmark (author)
  • Mellentin, Angelina IsabellaMental Hlth Serv Southern Denmark, Denmark; Univ Southern Denmark, Denmark; Univ Southern Denmark, Denmark; Univ Southern Denmark, Denmark (author)
  • Ebert, David DanielTech Univ Munich, Germany (author)
  • Titzler, IngridFriedrich Alexander Univ Erlangen Nurnberg, Germany (author)
  • Araya, RicardoKings Coll London, England (author)
  • Pashoja, Arlinda CergaLondon Sch Hyg & Trop Med, England; Publ Hlth England, England (author)
  • Haw, Jean-BaptisteHop Hotel Dieu, France; Univ Paris, France (author)
  • Holtzmann, JeromeFdn FondaMental, France; Grenoble Univ Hosp, France (author)
  • Cieslak, RomanSWPS Univ Social Sci & Humanities, Poland; Univ Colorado, CO USA (author)
  • Smoktunowicz, EwelinaSWPS Univ Social Sci & Humanities, Poland (author)
  • Banos, RosaUniv Valencia, Spain; CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Spain (author)
  • Herrero, RocioUniv Valencia, Spain; CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Spain (author)
  • Garcia-Palacios, AzucenaCIBER Fisiopatol Obesidad & Nutr CIBEROBN, Spain; Univ Jaume 1, Spain (author)
  • Botella, CristinaCIBER Fisiopatol Obesidad & Nutr CIBEROBN, Spain; Univ Jaume 1, Spain (author)
  • Berger, ThomasUniv Bern, Switzerland (author)
  • Krieger, TobiasUniv Bern, Switzerland (author)
  • Holmberg, Trine TheresaMental Hlth Serv Southern Denmark, Denmark; Univ Southern Denmark, Denmark (author)
  • Topooco, NairaLinköpings universitet,Psykologi,Filosofiska fakulteten,Palo Alto Univ, CA USA(Swepub:liu)naito42 (author)
  • Andersson, GerhardKarolinska Institutet,Linköpings universitet,Psykologi,Filosofiska fakulteten,Institutionen för biomedicinska och kliniska vetenskaper,Medicinska fakulteten,Karolinska Inst, Sweden(Swepub:liu)geran87 (author)
  • van Straten, AnnemiekeVrije Univ, Netherlands; Amsterdam Publ Hlth Res Inst, Netherlands (author)
  • Kemmeren, LiseVrije Univ, Netherlands (author)
  • Kleiboer, AnnetVrije Univ, Netherlands (author)
  • Riper, HeleenMental Hlth Serv Southern Denmark, Denmark; Vrije Univ, Netherlands (author)
  • Mathiasen, KimMental Hlth Serv Southern Denmark, Denmark; Univ Southern Denmark, Denmark; Aarhus Univ Hosp, Denmark (author)
  • Mental Hlth Serv Southern Denmark, Denmark; Univ Southern Denmark, DenmarkAarhus Univ Hosp, Denmark (creator_code:org_t)

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