Objective: Insomnia and major depressive disorders (MDD) often co-occur, and such comorbidity has been associated with poorer outcomes for both conditions. However, individual differences in depressive symptom trajectories during and after treatment are poorly understood in comorbid insomnia and depression. This study explored the heterogeneity in long-term depression change trajectories, and examined their correlates, particularly insomnia-related characteristics.

Method: Participants were 148 adults (age M ± SD = 46.6 ± 12.6, 73.0% female) with insomnia and MDD who received antidepressant pharmacotherapy, and were randomized to 7-session Cognitive Behavioral Therapy for Insomnia or control conditions over 16 weeks with 2-year follow-ups. Depression and insomnia severity were assessed at baseline, biweekly during treatment, and every 4 months thereafter. Sleep effort and beliefs about sleep were also assessed.

Results: Growth mixture modeling revealed three trajectories: (a) Partial-Responders (68.9%) had moderate symptom reduction during early treatment (p value < .001) and maintained mild depression during follow-ups. (b) Initial-Responders (17.6%) had marked symptom reduction during treatment (p values < .001) and low depression severity at posttreatment, but increased severity over follow-up (p value < .001). (c) Optimal-Responders (13.5%) achieved most gains during early treatment (p value < .001), continued to improve (p value < .01) and maintained minimal depression during follow-ups. The classes did not differ significantly on baseline measures or treatment received, but differed on insomnia-related measures after treatment began (p values < .05): Optimal-Responders consistently endorsed the lowest insomnia severity, sleep effort, and unhelpful beliefs about sleep.

Conclusions: Three depression symptom trajectories were observed among patients with comorbid insomnia and MDD. These trajectories were associated with insomnia-related constructs after commencing treatment. Early changes in insomnia characteristics may predict long-term depression outcomes. (PsycINFO Database Record

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5841584PMC
http://dx.doi.org/10.1037/ccp0000282DOI Listing

Publication Analysis

Top Keywords

long-term depression
12
depression
10
insomnia
9
insomnia depression
8
depression insomnia
8
predict long-term
8
symptom trajectories
8
treatment
8
comorbid insomnia
8
insomnia mdd
8

Similar Publications

Background/objectives: The COVID-19 pandemic has led to detrimental effects on diverse aspects of the mental and physical health of the general population worldwide. The elderly are more susceptible to COVID-19 infection compared to younger age groups. In this aspect, the purpose of the current survey is to evaluate the effect of the COVID-19 pandemic on the interrelationships among the sociodemographic and anthropometric characteristics, depressive behavior, quality of life, cognition status, physical activity and nutritional status of older adults.

View Article and Find Full Text PDF

Avoiding Chest Wall Morbidity in Outpatient Microvascular Free-Flap Breast Reconstruction.

J Clin Med

January 2025

My Houston Surgeons, 9230 Katy Freeway, Suite 600, Houston, TX 77055, USA.

Removal of the rib and adjacent cartilage is a common step for exposure of the recipient chest vessels in free-flap breast reconstructions. However, this adds both short- and long-term morbidity to the procedure. We describe our experience in avoiding rib removal in microvascular breast reconstruction.

View Article and Find Full Text PDF

Obesity represents a global epidemic associated with significant health risks, including diabetes, cardiovascular disease, and certain cancers. Management strategies have evolved from focusing solely on weight reduction to emphasizing overall health improvements and mitigating associated risks. This narrative review analyzed the existing peer-reviewed literature across databases such as PubMed, Scopus, EMBASE, the Cochrane Library, and Google Scholar to examine the outcomes of bariatric surgery and its interplay with weight stigma.

View Article and Find Full Text PDF

: Migraine is a complex neurological disorder often associated with autonomic nervous system (ANS) dysfunction. This study aimed to evaluate the effects of fascia exercises on migraine symptoms and explore their potential as a novel conservative treatment approach. : A prospective, randomized controlled trial was conducted with 30 migraine patients who were randomly assigned to a treatment group (fascia exercises) or a control group (conventional physiotherapy).

View Article and Find Full Text PDF

Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), is increasingly recognized as a condition affecting not only adults but also children and adolescents. While children often experience milder acute COVID-19 symptoms compared to adults, some develop persistent physical, psychological, and neurological symptoms lasting for weeks or months after initial infection. The most commonly reported symptoms include debilitating fatigue, respiratory issues, headaches, muscle pain, gastrointestinal disturbances, and cognitive difficulties, which significantly impact daily activities, schooling, and social interactions.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!