Identifying trajectories of change in sleep disturbance during psychological treatment for depression
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Authors
Zhang, Tian
Buckman, Joshua E. J.
Suh, Jae Won
Stott, Joshua
Singh, Satwant
Jena, Rahul
Naqvi, S.A.
Pilling, Steve
Cape, John
Saunders, Rob
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Issue Date
15/11/2024
Type
Journal article
Language
Keywords
Mental Health
Alternative Title
Abstract
Background
Sleep disturbance may impact response to psychological treatment for depression. Understanding how sleep disturbance changes during the course of psychological treatment, and identifying the risk factors for sleep disturbance response may inform clinical decision-making.
Method
This analysis included 18,915 patients receiving high-intensity psychological therapy for depression from one of eight London-based Improving Access to Psychological Therapies (IAPT) services between 2011 and 2020. Distinct trajectories of change in sleep disturbance were identified using growth mixture modelling. The study also investigated associations between identified trajectory classes, pre-treatment patient characteristics, and eventual treatment outcomes from combined PHQ-9 and GAD-7 metrics used by the services.
Results
Six distinct trajectories of sleep disturbance were identified: two demonstrated improvement, while one showed initial deterioration and the other three groups displayed only limited change in sleep disturbance, each with varying baseline sleep disturbance. Associations with trajectory class membership were found based on: gender, ethnicity, employment status, psychotropic medication use, long-term health condition status, severity of depressive symptoms, and functional impairment. Groups that showed improvement in sleep had the best eventual outcomes from depression treatment, followed by groups that consistently slept well.
Limitation
Single item on sleep disturbance used, no data on treatment adherence.
Description
Citation
Journal of Affective Disorders,
Volume 365,
2024,
Pages 659-668,
ISSN 0165-0327,
https://doi.org/10.1016/j.jad.2024.08.027.
Publisher
License
Journal
Journal of Affective Disorders
Volume
365