The Clinical Effectiveness of Cognitive Behavioral Therapy for Patients with Insomnia and Depression: A Systematic Review and Meta-Analysis
Background. Insomnia and depression often co-occurr. However, there is lack of effective treatment for such comorbidity. CBT-I has been recommended as the first-line treatment for insomnia; whether it is also effective for comorbidity of insomnia and depression is still unknown. Therefore, we conduc...
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| creator | Geng, Le Li, Xun Han, Mei Feng, Guiyu Miao, Yingchun |
| description | Background. Insomnia and depression often co-occurr. However, there is lack of effective treatment for such comorbidity. CBT-I has been recommended as the first-line treatment for insomnia; whether it is also effective for comorbidity of insomnia and depression is still unknown. Therefore, we conducted this meta-analysis of randomized controlled trials to assess the clinical effectiveness and safety of CBT-I for insomnia comorbid with depression. Data Sources. Seven electronic databases, including China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science Technology Journal Database, SinoMed Database, PubMed, the Cochrane Library, and EMBASE, as well as grey literature, were searched from the beginning of each database to July 1, 2019. Study Eligibility Criteria. Randomized controlled trials that compared CBT-I to no treatment or hypnotics (zopiclone, estazolam, and benzodiazepine agonist) for insomnia comorbid with depression and reported both insomnia scales and depression scales. Study Assessment and Synthesis Methods. Cochrane Reviewer’s Handbook was used for evaluating the risk of bias of included studies. Review Manager 5.3 software was used for meta-analysis. Online GRADEpro was used to assess the quality of evidence. Results. The pooled data showed that CBT-I was superior to no treatment for insomnia, while it was unsure whether CBT-I was better than no treatment for depression. And the effectiveness of CBT-I was comparable to hypnotics for both insomnia and depression. CBT-I was likely to be safe due to its noninvasive nature. The methodological quality varied across these trials. The evidence quality varied from moderate to very low, and the recommendation level was low. Conclusions. Currently, findings support that CBT-I seems to be effective and safe for insomnia comorbid with depression to improve the insomnia condition, while it is unsure whether CBT-I could improve depression condition. More rigorous trials are needed to confirm our findings. |
| doi_str_mv | 10.1155/2020/8071821 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7378630</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A639548495</galeid><sourcerecordid>A639548495</sourcerecordid><originalsourceid>FETCH-LOGICAL-c499t-515582400c2b46162558822ed480921960646d9d7c6d4b3daa7cee869a6aab6a3</originalsourceid><addsrcrecordid>eNqNkktvEzEUhUcIREthxxpZYoMEoX6NHyyQQihQqQgERWJn3XjuNK4mdhhPEuU38KdxmpACK1Z-fT73HPtW1WNGXzJW16eccnpqqGaGszvVMdOSjSQ35u5hrr8fVQ9yvqaUW631_epIcC1EbfRx9fNyhmTShRg8dOSsbdEPYYURcyapJZN0FcN2g7zBGaxC6gtVrvSw2JA29eQzDAHjkMk6DDNyHnOaxwAEYkPe4qIvMiHFV2RMvm7ygPNCe_IFVwHXN8xHHGA0jtBtcsgPq3stdBkf7ceT6tu7s8vJh9HFp_fnk_HFyEtrh1FdUhsuKfV8KhVTvCwN59hIQy1nVlElVWMb7VUjp6IB0B7RKAsKYKpAnFSvd7qL5XSOjS_-Syy36MMc-o1LENzfJzHM3FVaOS20UYIWgWd7gT79WGIe3Dxkj10HEdMyOy7LQxczShT06T_odVr2JfANpYtdy-pb6go6dCG2qdT1W1E3VsLW0ki7pV7sKN-nnHtsD5YZddtecNtecPteKPiTP2Me4N-fX4DnO2AWYgPr8J9y5RdLbbilWa2FFeIXvd3Fzg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2427219915</pqid></control><display><type>article</type><title>The Clinical Effectiveness of Cognitive Behavioral Therapy for Patients with Insomnia and Depression: A Systematic Review and Meta-Analysis</title><source>PubMed Central Open Access</source><source>Wiley Online Library Open Access</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>Geng, Le ; Li, Xun ; Han, Mei ; Feng, Guiyu ; Miao, Yingchun</creator><contributor>Toussaint, Loren ; Loren Toussaint</contributor><creatorcontrib>Geng, Le ; Li, Xun ; Han, Mei ; Feng, Guiyu ; Miao, Yingchun ; Toussaint, Loren ; Loren Toussaint</creatorcontrib><description>Background. Insomnia and depression often co-occurr. However, there is lack of effective treatment for such comorbidity. CBT-I has been recommended as the first-line treatment for insomnia; whether it is also effective for comorbidity of insomnia and depression is still unknown. Therefore, we conducted this meta-analysis of randomized controlled trials to assess the clinical effectiveness and safety of CBT-I for insomnia comorbid with depression. Data Sources. Seven electronic databases, including China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science Technology Journal Database, SinoMed Database, PubMed, the Cochrane Library, and EMBASE, as well as grey literature, were searched from the beginning of each database to July 1, 2019. Study Eligibility Criteria. Randomized controlled trials that compared CBT-I to no treatment or hypnotics (zopiclone, estazolam, and benzodiazepine agonist) for insomnia comorbid with depression and reported both insomnia scales and depression scales. Study Assessment and Synthesis Methods. Cochrane Reviewer’s Handbook was used for evaluating the risk of bias of included studies. Review Manager 5.3 software was used for meta-analysis. Online GRADEpro was used to assess the quality of evidence. Results. The pooled data showed that CBT-I was superior to no treatment for insomnia, while it was unsure whether CBT-I was better than no treatment for depression. And the effectiveness of CBT-I was comparable to hypnotics for both insomnia and depression. CBT-I was likely to be safe due to its noninvasive nature. The methodological quality varied across these trials. The evidence quality varied from moderate to very low, and the recommendation level was low. Conclusions. Currently, findings support that CBT-I seems to be effective and safe for insomnia comorbid with depression to improve the insomnia condition, while it is unsure whether CBT-I could improve depression condition. More rigorous trials are needed to confirm our findings.</description><identifier>ISSN: 1741-427X</identifier><identifier>EISSN: 1741-4288</identifier><identifier>DOI: 10.1155/2020/8071821</identifier><identifier>PMID: 32733587</identifier><language>eng</language><publisher>Cairo, Egypt: Hindawi Publishing Corporation</publisher><subject>Behavior modification ; Behavioral health care ; Benzodiazepines ; Bias ; Care and treatment ; Clinical medicine ; Clinical trials ; Cognitive ability ; Cognitive behavioral therapy ; Cognitive therapy ; Comorbidity ; Depression, Mental ; Hygiene ; Hypnotics ; Insomnia ; Intervention ; Mental depression ; Meta-analysis ; Quality ; Review ; Sedatives ; Sleep ; Sleep disorders ; Suicides & suicide attempts ; Systematic review ; Type 2 diabetes ; Zopiclone</subject><ispartof>Evidence-based complementary and alternative medicine, 2020, Vol.2020 (2020), p.1-14</ispartof><rights>Copyright © 2020 Guiyu Feng et al.</rights><rights>COPYRIGHT 2020 John Wiley & Sons, Inc.</rights><rights>Copyright © 2020 Guiyu Feng et al. This is an open access article distributed under the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. http://creativecommons.org/licenses/by/4.0</rights><rights>Copyright © 2020 Guiyu Feng et al. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c499t-515582400c2b46162558822ed480921960646d9d7c6d4b3daa7cee869a6aab6a3</citedby><cites>FETCH-LOGICAL-c499t-515582400c2b46162558822ed480921960646d9d7c6d4b3daa7cee869a6aab6a3</cites><orcidid>0000-0002-7728-2080 ; 0000-0001-6883-3891</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7378630/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7378630/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,4024,27923,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32733587$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Toussaint, Loren</contributor><contributor>Loren Toussaint</contributor><creatorcontrib>Geng, Le</creatorcontrib><creatorcontrib>Li, Xun</creatorcontrib><creatorcontrib>Han, Mei</creatorcontrib><creatorcontrib>Feng, Guiyu</creatorcontrib><creatorcontrib>Miao, Yingchun</creatorcontrib><title>The Clinical Effectiveness of Cognitive Behavioral Therapy for Patients with Insomnia and Depression: A Systematic Review and Meta-Analysis</title><title>Evidence-based complementary and alternative medicine</title><addtitle>Evid Based Complement Alternat Med</addtitle><description>Background. Insomnia and depression often co-occurr. However, there is lack of effective treatment for such comorbidity. CBT-I has been recommended as the first-line treatment for insomnia; whether it is also effective for comorbidity of insomnia and depression is still unknown. Therefore, we conducted this meta-analysis of randomized controlled trials to assess the clinical effectiveness and safety of CBT-I for insomnia comorbid with depression. Data Sources. Seven electronic databases, including China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science Technology Journal Database, SinoMed Database, PubMed, the Cochrane Library, and EMBASE, as well as grey literature, were searched from the beginning of each database to July 1, 2019. Study Eligibility Criteria. Randomized controlled trials that compared CBT-I to no treatment or hypnotics (zopiclone, estazolam, and benzodiazepine agonist) for insomnia comorbid with depression and reported both insomnia scales and depression scales. Study Assessment and Synthesis Methods. Cochrane Reviewer’s Handbook was used for evaluating the risk of bias of included studies. Review Manager 5.3 software was used for meta-analysis. Online GRADEpro was used to assess the quality of evidence. Results. The pooled data showed that CBT-I was superior to no treatment for insomnia, while it was unsure whether CBT-I was better than no treatment for depression. And the effectiveness of CBT-I was comparable to hypnotics for both insomnia and depression. CBT-I was likely to be safe due to its noninvasive nature. The methodological quality varied across these trials. The evidence quality varied from moderate to very low, and the recommendation level was low. Conclusions. Currently, findings support that CBT-I seems to be effective and safe for insomnia comorbid with depression to improve the insomnia condition, while it is unsure whether CBT-I could improve depression condition. More rigorous trials are needed to confirm our findings.</description><subject>Behavior modification</subject><subject>Behavioral health care</subject><subject>Benzodiazepines</subject><subject>Bias</subject><subject>Care and treatment</subject><subject>Clinical medicine</subject><subject>Clinical trials</subject><subject>Cognitive ability</subject><subject>Cognitive behavioral therapy</subject><subject>Cognitive therapy</subject><subject>Comorbidity</subject><subject>Depression, Mental</subject><subject>Hygiene</subject><subject>Hypnotics</subject><subject>Insomnia</subject><subject>Intervention</subject><subject>Mental depression</subject><subject>Meta-analysis</subject><subject>Quality</subject><subject>Review</subject><subject>Sedatives</subject><subject>Sleep</subject><subject>Sleep disorders</subject><subject>Suicides & suicide attempts</subject><subject>Systematic review</subject><subject>Type 2 diabetes</subject><subject>Zopiclone</subject><issn>1741-427X</issn><issn>1741-4288</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>RHX</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqNkktvEzEUhUcIREthxxpZYoMEoX6NHyyQQihQqQgERWJn3XjuNK4mdhhPEuU38KdxmpACK1Z-fT73HPtW1WNGXzJW16eccnpqqGaGszvVMdOSjSQ35u5hrr8fVQ9yvqaUW631_epIcC1EbfRx9fNyhmTShRg8dOSsbdEPYYURcyapJZN0FcN2g7zBGaxC6gtVrvSw2JA29eQzDAHjkMk6DDNyHnOaxwAEYkPe4qIvMiHFV2RMvm7ygPNCe_IFVwHXN8xHHGA0jtBtcsgPq3stdBkf7ceT6tu7s8vJh9HFp_fnk_HFyEtrh1FdUhsuKfV8KhVTvCwN59hIQy1nVlElVWMb7VUjp6IB0B7RKAsKYKpAnFSvd7qL5XSOjS_-Syy36MMc-o1LENzfJzHM3FVaOS20UYIWgWd7gT79WGIe3Dxkj10HEdMyOy7LQxczShT06T_odVr2JfANpYtdy-pb6go6dCG2qdT1W1E3VsLW0ki7pV7sKN-nnHtsD5YZddtecNtecPteKPiTP2Me4N-fX4DnO2AWYgPr8J9y5RdLbbilWa2FFeIXvd3Fzg</recordid><startdate>2020</startdate><enddate>2020</enddate><creator>Geng, Le</creator><creator>Li, Xun</creator><creator>Han, Mei</creator><creator>Feng, Guiyu</creator><creator>Miao, Yingchun</creator><general>Hindawi Publishing Corporation</general><general>Hindawi</general><general>John Wiley & Sons, Inc</general><general>Hindawi Limited</general><scope>ADJCN</scope><scope>AHFXO</scope><scope>RHU</scope><scope>RHW</scope><scope>RHX</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88G</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M2M</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-7728-2080</orcidid><orcidid>https://orcid.org/0000-0001-6883-3891</orcidid></search><sort><creationdate>2020</creationdate><title>The Clinical Effectiveness of Cognitive Behavioral Therapy for Patients with Insomnia and Depression: A Systematic Review and Meta-Analysis</title><author>Geng, Le ; Li, Xun ; Han, Mei ; Feng, Guiyu ; Miao, Yingchun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c499t-515582400c2b46162558822ed480921960646d9d7c6d4b3daa7cee869a6aab6a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Behavior modification</topic><topic>Behavioral health care</topic><topic>Benzodiazepines</topic><topic>Bias</topic><topic>Care and treatment</topic><topic>Clinical medicine</topic><topic>Clinical trials</topic><topic>Cognitive ability</topic><topic>Cognitive behavioral therapy</topic><topic>Cognitive therapy</topic><topic>Comorbidity</topic><topic>Depression, Mental</topic><topic>Hygiene</topic><topic>Hypnotics</topic><topic>Insomnia</topic><topic>Intervention</topic><topic>Mental depression</topic><topic>Meta-analysis</topic><topic>Quality</topic><topic>Review</topic><topic>Sedatives</topic><topic>Sleep</topic><topic>Sleep disorders</topic><topic>Suicides & suicide attempts</topic><topic>Systematic review</topic><topic>Type 2 diabetes</topic><topic>Zopiclone</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Geng, Le</creatorcontrib><creatorcontrib>Li, Xun</creatorcontrib><creatorcontrib>Han, Mei</creatorcontrib><creatorcontrib>Feng, Guiyu</creatorcontrib><creatorcontrib>Miao, Yingchun</creatorcontrib><collection>الدوريات العلمية والإحصائية - e-Marefa Academic and Statistical Periodicals</collection><collection>معرفة - المحتوى العربي الأكاديمي المتكامل - e-Marefa Academic Complete</collection><collection>Hindawi Publishing Complete</collection><collection>Hindawi Publishing Subscription Journals</collection><collection>Hindawi Publishing Open Access Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Psychology Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Evidence-based complementary and alternative medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Geng, Le</au><au>Li, Xun</au><au>Han, Mei</au><au>Feng, Guiyu</au><au>Miao, Yingchun</au><au>Toussaint, Loren</au><au>Loren Toussaint</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Clinical Effectiveness of Cognitive Behavioral Therapy for Patients with Insomnia and Depression: A Systematic Review and Meta-Analysis</atitle><jtitle>Evidence-based complementary and alternative medicine</jtitle><addtitle>Evid Based Complement Alternat Med</addtitle><date>2020</date><risdate>2020</risdate><volume>2020</volume><issue>2020</issue><spage>1</spage><epage>14</epage><pages>1-14</pages><issn>1741-427X</issn><eissn>1741-4288</eissn><abstract>Background. Insomnia and depression often co-occurr. However, there is lack of effective treatment for such comorbidity. CBT-I has been recommended as the first-line treatment for insomnia; whether it is also effective for comorbidity of insomnia and depression is still unknown. Therefore, we conducted this meta-analysis of randomized controlled trials to assess the clinical effectiveness and safety of CBT-I for insomnia comorbid with depression. Data Sources. Seven electronic databases, including China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science Technology Journal Database, SinoMed Database, PubMed, the Cochrane Library, and EMBASE, as well as grey literature, were searched from the beginning of each database to July 1, 2019. Study Eligibility Criteria. Randomized controlled trials that compared CBT-I to no treatment or hypnotics (zopiclone, estazolam, and benzodiazepine agonist) for insomnia comorbid with depression and reported both insomnia scales and depression scales. Study Assessment and Synthesis Methods. Cochrane Reviewer’s Handbook was used for evaluating the risk of bias of included studies. Review Manager 5.3 software was used for meta-analysis. Online GRADEpro was used to assess the quality of evidence. Results. The pooled data showed that CBT-I was superior to no treatment for insomnia, while it was unsure whether CBT-I was better than no treatment for depression. And the effectiveness of CBT-I was comparable to hypnotics for both insomnia and depression. CBT-I was likely to be safe due to its noninvasive nature. The methodological quality varied across these trials. The evidence quality varied from moderate to very low, and the recommendation level was low. Conclusions. Currently, findings support that CBT-I seems to be effective and safe for insomnia comorbid with depression to improve the insomnia condition, while it is unsure whether CBT-I could improve depression condition. More rigorous trials are needed to confirm our findings.</abstract><cop>Cairo, Egypt</cop><pub>Hindawi Publishing Corporation</pub><pmid>32733587</pmid><doi>10.1155/2020/8071821</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-7728-2080</orcidid><orcidid>https://orcid.org/0000-0001-6883-3891</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Behavior modification Behavioral health care Benzodiazepines Bias Care and treatment Clinical medicine Clinical trials Cognitive ability Cognitive behavioral therapy Cognitive therapy Comorbidity Depression, Mental Hygiene Hypnotics Insomnia Intervention Mental depression Meta-analysis Quality Review Sedatives Sleep Sleep disorders Suicides & suicide attempts Systematic review Type 2 diabetes Zopiclone |
| title | The Clinical Effectiveness of Cognitive Behavioral Therapy for Patients with Insomnia and Depression: A Systematic Review and Meta-Analysis |
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