@Article{作者信息:doi / 10.2196/30231 = " Jensen Esben Skov Ladegaard,尼科莱Mellentin,安吉丽娜伊莎贝拉和艾伯特,大卫·丹尼尔和Titzler英格丽·阿瑞亚,里卡多和Cerga Pashoja, Arlinda Hazo,让-巴蒂斯特·Holtzmann, J {\ ' r e} {\ ^ o}我Cieslak,罗马和Smoktunowicz Ewelina和英航{\ ~ {n}}操作系统,罗莎写到,Rocio和Garc{\ '(我}a-Palacios Azucena Botella,克里斯蒂娜•伯杰,托马斯和Krieger,托拜厄斯霍姆博格,三重的特里萨和Topooco,Naira和Andersson, Gerhard和van Straten, Annemieke和Kemmeren, Lise和Kleiboer, Annet和Riper, Heleen和Mathiasen, Kim，标题=“睡眠障碍症状对抑郁症混合认知行为疗法治疗结果的影响(e - compare研究):二次分析”，期刊=“J Med Internet Res”，年=“2022”，月=“Mar”，日=“21”，量=“24”，数=“3”，页=“e30231”，关键词=“混合护理;bCBT;认知行为疗法;数字的干预;重度抑郁症;睡眠障碍;睡眠障碍;心理健康;数字健康; mobile phone", abstract="Background: Sleep disturbance symptoms are common in major depressive disorder (MDD) and have been found to hamper the treatment effect of conventional face-to-face psychological treatments such as cognitive behavioral therapy. To increase the dissemination of evidence-based treatment, blended cognitive behavioral therapy (bCBT) consisting of web-based and face-to-face treatment is on the rise for patients with MDD. To date, no study has examined whether sleep disturbance symptoms have an impact on bCBT treatment outcomes and whether it affects bCBT and treatment-as-usual (TAU) equally. Objective: The objectives of this study are to investigate whether baseline sleep disturbance symptoms have an impact on treatment outcomes independent of treatment modality and whether sleep disturbance symptoms impact bCBT and TAU in routine care equally. Methods: The study was based on data from the E-COMPARED (European Comparative Effectiveness Research on Blended Depression Treatment Versus Treatment-as-Usual) study, a 2-arm, multisite, parallel randomized controlled, noninferiority trial. A total of 943 outpatients with MDD were randomized to either bCBT (476/943, 50.5{\%}) or TAU consisting of routine clinical MDD treatment (467/943, 49.5{\%}). The primary outcome of this study was the change in depression symptom severity at the 12-month follow-up. The secondary outcomes were the change in depression symptom severity at the 3- and 6-month follow-up and MDD diagnoses at the 12-month follow-up, assessed using the Patient Health Questionnaire-9 and Mini-International Neuropsychiatric Interview, respectively. Mixed effects models were used to examine the association of sleep disturbance symptoms with treatment outcome and treatment modality over time. Results: Of the 943 patients recruited for the study, 558 (59.2{\%}) completed the 12-month follow-up assessment. In the total sample, baseline sleep disturbance symptoms did not significantly affect change in depressive symptom severity at the 12-month follow-up ($\beta$=.16, 95{\%} CI --0.04 to 0.36). However, baseline sleep disturbance symptoms were negatively associated with treatment outcome for bCBT ($\beta$=.49, 95{\%} CI 0.22-0.76) but not for TAU ($\beta$=--.23, 95{\%} CI −0.50 to 0.05) at the 12-month follow-up, even when adjusting for baseline depression symptom severity. The same result was seen for the effect of sleep disturbance symptoms on the presence of depression measured with Mini-International Neuropsychiatric Interview at the 12-month follow-up. However, for both treatment formats, baseline sleep disturbance symptoms were not associated with depression symptom severity at either the 3- ($\beta$=.06, 95{\%} CI −0.11 to 0.23) or 6-month ($\beta$=.09, 95{\%} CI −0.10 to 0.28) follow-up. Conclusions: Baseline sleep disturbance symptoms may have a negative impact on long-term treatment outcomes in bCBT for MDD. This effect was not observed for TAU. These findings suggest that special attention to sleep disturbance symptoms might be warranted when MDD is treated with bCBT. Future studies should investigate the effect of implementing modules specifically targeting sleep disturbance symptoms in bCBT for MDD to improve long-term prognosis. ", issn="1438-8871", doi="10.2196/30231", url="//www.mybigtv.com/2022/3/e30231", url="https://doi.org/10.2196/30231", url="http://www.ncbi.nlm.nih.gov/pubmed/35311687" }