Effects of Group Cognitive Behavioural Therapy on Comorbid Insomnia and Depression in Youth
Condition: Insomnia; Depression
MeSH terms: Sleep Initiation and Maintenance Disorders; Depression; Depressive Disorder
Study type: Interventional

Summary: 
      Major depressive disorder (MDD) is among the most common psychiatric disorders among
      adolescents, and is associated with considerable psychosocial and functional impairments and
      an elevated risk of suicidal behaviour and completed suicide. Meanwhile, sleep disturbance,
      particularly insomnia, is among the most prevalent and prominent presenting complaints in
      adolescents with depression. Despite its high prevalence, insomnia often remains overlooked
      and under-treated in clinical practice. However, growing evidence suggests an intricate
      relationship between insomnia and depression, which has become an area in need of further
      focused attention. This project will involve a randomised controlled trial proposed to
      examine whether insomnia treatment confers additional benefit to depression treatment in
      adolescents with comorbid depression and insomnia, for improving sleep and depressive
      symptoms, and other clinical and daytime symptoms as well as overall functional improvement
      in both the short and long term. Eligible adolescent participants will be randomised to
      either intervention (8-week group Cognitive Behavioural Therapy for Insomnia, CBT-I, or
      8-week group Cognitive Behavioural Therapy for Depression, CBT-D) or waiting-list control
      condition. Assessments will be conducted at pre-treatment (week 0), during the treatment
      (week 2, 4, 6) and post-treatment (week 8/at the conclusion of the last group session). The
      two active treatment groups will be additionally followed up at posttreatment one-month and
      six-month.
    


Intervention name(s): Cognitive Behavioural Therapy for Insomnia (CBT-I); Cognitive Behavioural Therapy for Depression (CBT-D)
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The intervention will consist of 8 weekly group sessions (90-min, 5-8 adolescents in each group) of CBT-I delivered within a 10-week window. The treatment components in the CBT-I aim to address the behavioural, cognitive and physiological perpetuating factor of insomnia and include: psycho-education about sleep and sleep hygiene, stimulus control, sleep restriction, relaxation training, structured worry time, cognitive restructuring (targeting sleep-related dysfunctional cognitions), and relapse prevention.; The intervention will consist of 8 weekly group sessions (90-min, 5-8 adolescents in each group) of CBT-D delivered within a 10-week window. The main treatment elements of CBT-D include: psycho-education about depression, self-monitoring, behavioural activation, improving social skills, communication skills and problem solving skills, cognitive restructuring (addressing negative and irrational thoughts often associated with depression in adolescents), relaxation techniques, and relapse prevention.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Insomnia; Depression; Adolescents; Youth