Transdiagnostic Self-Help Cognitive Behavioral Therapy for Insomnia on Depressive Symptoms : A Systematic Review and Meta -Analysis

Abstract

Sleep disturbances commonly occur in patients with depression. To date, insomnia is considered not only a symptom of but also a risk factor of depression. This study aimed to review current literature, examine the efficacy of transdiagnostic self-help cognitive behavioral therapy for insomnia (CBT-I) on depressive symptoms, and to explore possible factors that might contribute to the effectiveness of the treatment. A systematic review was performed up to March 2016 on studies published in 6 major electronic databases. Two researchers were responsible for study identification, data extraction, and methodological quality evaluation according to the Cochrane criteria. A total of 2,510 potentially relevant citations were identified, and 19 randomized controlled trials that compared self-help CBT-I vs. waiting-list, routine care, or no treatment, therapist-administered CBT-I, group CBT-I and placebo were included. Random effects models showed significant reduction in self-report depressive symptoms in the self-help CBT-I group when compared to the waiting-list control group (Hedges’ g = 0.61). Transdiagnostic CBT-I appears to be efficacious in treating depressive symptoms. Based on the results of the systematic review, we have designed a transdiagnostic CBT-I smartphone application “proACT-S” to evaluate the preliminary effectiveness and feasibility in Chinese population.