Citation

Gebara MA, Siripong N, DiNapoli EA, Maree RD, Germain A, Reynolds CF, Kasckow JW, Weiss PM, Karp JF. Depress. Anxiety 2018; 35(8): 717-731.

Affiliation

Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Copyright

(Copyright © 2018, John Wiley and Sons)

DOI

10.1002/da.22776

PMID

29782076

Abstract

BACKGROUND: Insomnia is frequently co-morbid with depression, with a bidirectional relationship between these disorders. There is evidence that insomnia-specific interventions, such as cognitive behavioral therapy for insomnia, may lead to improvements in depression. The purpose of this systematic review and meta-analysis is to determine whether treatment of insomnia leads to improved depression outcomes in individuals with both insomnia and depression.

METHODS: We conduct a systematic review and meta-analysis to explore the effect of treatment for insomnia disorder on depression in patients with both disorders.

RESULTS: Three thousand eight hundred and fifteen studies were reviewed, and 23 studies met inclusion criteria. Although all of the studies suggested a positive clinical effect of insomnia treatment on depression outcomes, most of the results were not statistically significant. Although the interventions and populations were highly variable, the meta-analysis indicates moderate to large effect size (ES) improvement in depression as measured with the Hamilton Depression Rating Scale (ES = -1.29, 95%CI [-2.11, -0.47]) and Beck Depression Inventory (ES = -0.68, 95%CI [-1.29, -0.06]).

CONCLUSIONS: These results support that treating insomnia in patients with depression has a positive effect on mood. Future trials are needed to identify the subtypes of patients whose depression improves during treatment with insomnia-specific interventions, and to identify the mechanisms by which treating insomnia improves mood.

© 2018 Wiley Periodicals, Inc.

Language: en

Keywords

cognitive therapy; comorbidity; depressive disorder; major; remission induction; sleep initiation and maintenance disorders