Citation

Jernelöv S, Forsell E, Kaldo V, Blom K. Front. Psychiatry 2021; 12.

Copyright

(Copyright © 2021, Frontiers Media)

DOI

10.3389/fpsyt.2021.676962

PMID

unavailable

Abstract

Insomnia disorder is highly prevalent, and has been identified as a risk factor for many psychiatric problems, including depression, suicide ideation and suicide death. Previous studies have found that cognitive behavioral therapy for insomnia (CBT-I) reduce depression and suicidal ideation in samples with high levels of suicidal ideation. This study aims to investigate associations of CBT-I with suicidal ideation in a sample of 522 patients primarily seeking internet-delivered treatment for insomnia in regular psychiatric care. The sample had high pretreatment insomnia severity levels and a relatively high level of comorbid depression symptoms. Suicidal ideation levels were relatively low pretreatment but still improved significantly after CBT-I. Contrary to previous findings, the strongest predictor of changes in suicidal ideation were improvements in depressive symptoms, rather than improvements in insomnia. We conclude that suicidal ideation may not be a major problem in these patients primarily seeking treatment for insomnia, despite comorbid depressive symptoms, but that suicidal ideation still improves following CBT-i. Considering the increased risk for patients with untreated insomnia to develop depression, this finding is of interest for prevention of suicidal ideation. © Copyright © 2021 Jernelöv, Forsell, Kaldo and Blom.

Language: en

Keywords

adult; human; female; male; bipolar disorder; insomnia; suicidal ideation; depression; prevalence; psychosis; education; risk assessment; prediction; major clinical study; mental health care; sleep disorder; intellectual impairment; Montgomery Asberg Depression Rating Scale; Article; DSM-5; sleep quality; Patient Health Questionnaire 9; cognitive behavioral therapy; Insomnia Severity Index; sleep hygiene; cognitive behavioral treatment for insomnia