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首页> 外文期刊>The journal of clinical psychiatry >A comparison of rates of residual insomnia symptoms following pharmacotherapy or cognitive-behavioral therapy for major depressive disorder.
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A comparison of rates of residual insomnia symptoms following pharmacotherapy or cognitive-behavioral therapy for major depressive disorder.

机译：抑郁症药物治疗或认知行为治疗后残留失眠症状发生率的比较。

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OBJECTIVE: A number of pharmacologic studies have documented that insomnia is among the most commonly reported residual symptoms after remission from depression. Residual symptoms after remission are particularly relevant because these symptoms confer greater risk for subsequent depression. This study was the first to date to examine residual insomnia after cognitive-behavioral therapy (CBT) for depression and to compare CBT with pharmacotherapy for depression on residual insomnia rates. METHOD: This naturalistic study examined rates of posttreatment insomnia complaints in patients (N = 94) who had been diagnosed with major depressive disorder (MDD), according to DSM-IV criteria, and who remitted from MDD after completing at least 20 weeks of either CBT or pharmacotherapy at an outpatient clinic specializing in mood disorders. Participants were randomly assigned to the treatment conditions, but only the data from those who completed treatment and remitted were analyzed. Primary outcome measure was the 17-item Hamilton Rating Scale for Depression. Data were collected from October 1, 1999, to September 23, 2003. Groups were compared using a chi(2) for nominal data. RESULTS: The rate of posttreatment insomnia was 22% for sleep-onset insomnia, 26% for sleep-maintenance insomnia, and 17% for early morning awakenings, and the rates did not statistically differ across the 2 treatment groups. CONCLUSION: Although CBT and pharmacotherapy effectively addressed depression in these patients and addressed insomnia symptoms for many, there were a number of patients with residual insomnia. Whereas there appears to be no difference between CBT and pharmacotherapy with regard to rates of residual insomnia, the rates of such insomnia remaining after these treatments suggest that adjunctive sleep treatment to specifically address insomnia may be necessary for some MDD patients.
机译：目的：许多药理学研究表明，失眠是抑郁症缓解后最常报告的残留症状之一。缓解后的残留症状特别相关，因为这些症状会给以后的抑郁症带来更大的风险。这项研究是迄今为止迄今为止首次针对抑郁症的认知行为疗法（CBT）检查残留失眠症，并将CBT与药物疗法对抑郁症的残留失眠率进行比较。方法：这项自然研究调查了根据DSM-IV标准诊断为重度抑郁症（MDD）并完成至少20周的MDD缓解的患者（N = 94）的治疗后失眠投诉率在专攻情绪障碍的门诊诊所进行CBT或药物疗法。参与者被随机分配到治疗条件中，但是仅分析来自完成治疗并被汇出的数据。主要结果指标是17个项目的汉密尔顿抑郁量表。从1999年10月1日到2003年9月23日收集数据。使用chi（2）比较组作为名义数据。结果：睡眠发作性失眠的治疗后失眠率为22％，睡眠维持性失眠的率为26％，清晨醒来的率为17％，并且在两个治疗组中，失眠率的差异无统计学意义。结论：尽管CBT和药物疗法有效地解决了这些患者的抑郁症并解决了许多人的失眠症状，但仍有许多患者残留有失眠症。尽管CBT和药物疗法在残留失眠率方面似乎没有差异，但是这些治疗后残留的失眠率表明，某些MDD患者可能需要进行辅助性睡眠治疗以专门解决失眠。

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