![]() ![]() Irwin MR, Carrillo C, Sadeghi N, Bjurstrom MF, Breen EC, Olmstead R. I think that CBT-I should be applied to some cases of mental disorders.ġ. There are many risk factors of insomnia in older subjects, and risk of incident and recurrent major depression may not be highly observed in subjects with insomnia. I agree that treatment of insomnia with CBT-I is effective for the prevention of incident and recurrent major depression in older adults with insomnia.īut I do not agree with the proposal that community-level screening for insomnia in older adults and wide delivery of CBT-I-based treatment for insomnia can be recommended. In addition, HR of the CBT-I group with sustained remission of insomnia disorder against the SET group without sustained remission of insomnia disorder for depression was 0.17 (0.04-0.73). Hazard ratio (HR) (95% CI) of CBT-I against SET for incident or recurrent major depression was 0.51 (0.29-0.88). Sleep education therapy (SET) was set as a control. conducted a randomized clinical trial to evaluate the effect of cognitive behavioral therapy for insomnia (CBT-I) on older adults with incident and recurrent depression (1). Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.Time to Incident Depression Event by Percentage Duration Insomnia Remission Time to Incident Depression Event by Insomnia Remission Sustained Over 36 MonthsĮFigure 3. Time to Incident Depression Event by Treatment Group in Sample With DSM-5 Insomnia DisorderĮFigure 2. Probability of Incident Depression in Participants With Sustained Insomnia Remission, as Compared to No Sustained Insomnia Remission, Over 36 Months Follow-up, Expressed as Hazard Ratio (HR) With 95% CIĮFigure 1. ![]() Probability of Incident Depression During 36-Month Follow-up in CBT-I Treatment Group, as Compared to SET, Expressed as Hazard Ratio (HR) With 95% CIĮTable 6. Characteristics of Participants by Treatment Group, at Entry Into Extended Follow-upĮTable 5. Characteristics of Participants by Treatment Group as a Function of Discontinuation, at 24 Months Follow-upĮTable 4. Characteristics of Participants by Treatment Group as a Function of Discontinuation, at Completion of TreatmentĮTable 3. Number and Proportion of Participants Retained at Each Assessment IntervalĮTable 2. CBT-I indicates cognitive behavioral therapy for insomnia SET, sleep education therapy.ĮTable 1. The HRs for some subgroups had wide 95% CIs owing to the small number of patients. The HRs were estimated on the basis of a unadjusted Cox proportional hazards regression model. 29 The no-effect point is 1 on the x-axis the dashed vertical line indicates the hazard ratio (HR) of 0.51 for the total sample. All participants fulfilled International Classification for Sleep Disorder, Second Edition and DSM-IV criteria for insomnia a subsample met the duration criteria for insomnia disorder as specified by DSM-5. Comorbidity was evaluated by the Charlson Comorbidity Index, with higher scores indicating greater comorbidity disability. Because 241 individuals (82.8%) in the sample were White, sizes for other ethnic groups (ie, 7 Asian, 32 Black, 3 Pacific Islander, 6 multiracial) were too small for statistical comparisons. Percentages may not total 100 because of rounding. ![]()
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