Self-referral to group cognitive behavioural therapy: Is it effective for treating chronic insomnia?

[Does a short telemedicine-based CBT programme for insomnia lead to changes in dysfunctional beliefs about sleep?]

INTRODUCTION

The Morphee Sleep network runs a short group CBT programme. During the pandemic, the programme was administered by videoconference. The programme focuses on behavioral modification. The objective of our study was to evaluate whether the videoconference programme produced changes in dysfunctional beliefs about sleep and whether these changes were linked to improvements in insomnia.

METHODS

Observational study of 3×90minute sessions of group CBT by videoconference over one month delivered by experienced psychologists. The outcome measures : insomnia severity scale (ISI), dysfunctional beliefs and attitudes about sleep short version (DBAS 16), hospital anxiety and depression scale (subscales depression HADD and anxiety HADA), and epworth sleepiness scale (ESS) completed before session 1 and at the end of session 3. The effectiveness of the programme on insomnia was evaluated by the decrease in the ISI score : full response R+ (>7 points), partial response, R- (4 - 6 points) non response, NR (<3 points). The effect on dysfunctional beliefs and attitudes about sleep were measured by the decrease in the DBAS 16 with response CR (>9 points) and no response CNR (<9 points).

RESULTS

There were fifty-five participants, 64 % women with a mean age of 49.1±16.1 years. The DBAS 16 was reduced by 6.12±1.29 to 5.09±1.57 (P< 0.0001) with 67 % of participants showing a response CR. The ISI score reduced from 17.7±3.6 to 14.0±4.9 (P< 0.0001) with 49 % showing at least a partial response (R+ and R-). A significant correlation (0.327, P=0.015) between the CBT response and dysfunctional beliefs about sleep was observed with a significant reduction in the DBAS 16 between responders R+ and non-responders (R+ vs. NR 1.67±1.3 vs. 0.57±1.28 P=0.012). Seventy-nine of R+ showed improvements in the DBAS 16 vs. 69 % of R- and 61 % of non-responders NR.

CONCLUSION

A short group CBT programme by videoconference focused on behavioral modification can reduce dysfunctional beliefs about sleep.

Efficacy of Virtual Cognitive Behavioral Therapy on COVID-19 Pandemic Related Anxiety in a Middle Eastern Country: An Interventional Study

Introduction

Emotional stress and anxiety during COVID-19 pandemic has gained a lot of attention. The capacity to withstand from the manipulated thinking and COVID-19 related stress and anxiety depends on the resilience level of an individual. Cognitive behavioral therapy (CBT) has patronizing benefits for people affected with altered mental health. Relieving COVID-19 related anxiety using CBT has beneficial impact on health and improves quality of life of people.

Objective

Aimed to relieve the anxiety of Omani population during COVID-19 pandemic using CBT.

Methods

This research utilized a pre-experimental one group pre-test post-test design. A non-probability convenient sampling technique was used to select 96 Omani people who fulfilled the inclusion criteria. The pre-anxiety level was assessed using CAS (Corona virus Anxiety Scale). The participants who scored above nine in the scale were given three sessions of CBT. Post-anxiety level was assessed using CAS after three CBT sessions.

Results

The study revealed that the level of anxiety reduced during post-test (6.35) after intervention when compared to pre-test (13.22). The CBT intervention was effective in reducing the anxiety in the post-test at p ≤ .000.

Conclusion

CBT is effective in reducing COVID-19 related anxiety among the Omani population. Therefore, this strategy is highly recommended in people having mental health issues.

Effect of cognitive behavioral therapy program on mental health status among medical student in Palestine during COVID pandemic

BACKGROUND

The COVID-19 pandemic had a profound psychological influence on everyone in society, and the impact it had on students, particularly medical students, cannot be underestimated. The main purpose of this study is to (1) determine the prevalence of mental disorders among medical students and their associated factors, and (2) examine the effectiveness of cognitive behavior therapy on mental health problems among medical students.

METHODS

Between March and May 2021, we conducted a randomized controlled study on two phases among medical students at An-Najah National University. Data were collected using an online questionnaire and the Arabic version of the 12-item General Health Questionnaire (GHQ-12). We also used the MEDAS tool to assess their Mediterranean Diet (MD) adherence. In the second phase, sixty-six students were recruited and assigned randomly to control and intervention groups. Intervention impact was assessed using 12-item General Health Questionnaire at two-time points; baseline, and 8 weeks post-intervention. The interventional model used was cognitive behavioral therapy, and the control group received no treatment.

RESULTS

A total of 329 students were included in the analysis of the first phase of the study. Approximately 28% of students had mental health problems. We found a significant relationship between good mental health status with a higher level of physical activity level, longer sleeping hours, and shorter entertainment time (p < 0.05). In the second phase of the study, a total of 91 students were included. Overall, using the CBT program showed a significant improvement in the outcome measures. At 8 weeks post-intervention, students had lower scores on total GHQ-12, depression, anxiety, and social dysfunction.

CONCLUSION

These findings propose that adequate attention must be paid to the mental health of medical students and that CBT programs can be used for the management of mental health problems among medical students.

Efficacy of cognitive behavioral therapy on mood and quality of life for patients with COVID-19: A protocol for systematic review and meta-analysis

BACKGROUND

There is no study that has conducted a review or meta-analysis investigating a cognitive behavioral therapy (CBT) intervention to patients with COVID19, with the aim of improving their psychological health. Therefore, in order to provide new evidence-based medical evidence for clinical treatment, we undertook a systematic review and meta-analysis to assess the effectiveness of CBT in relieving patients' psychological distress and improving quality of life during the COVID-19 epidemic.

METHODS

Seven electronic databases including Web of Science, Embase, PubMed, Wanfang Data, Scopus, Science Direct, Cochrane Library will be searched in April 2021 by 2 independent reviewers. For search on PubMed, the following search terms will be used: "COVID-19, 2019 Coronavirus Disease, 2019-nCoV, cognitive behavioral therapy, CBT, cognitive behavioral treatment." In order to achieve a consistency (at least 80%) of extracted items, the data extractors will extract data from a sample of eligible studies. The outcomes include any rating scale describing stress, mood, and quality of life. Review Manager software (v 5.4; Cochrane Collaboration) will be used for the meta-analysis. Two independent reviewers will assess the risk of bias of the included studies at study level. Any disagreements will be discussed and resolved in discussion with a third reviewer.

RESULTS

The results of our review will be reported strictly following the PRISMA criteria.

CONCLUSIONS

The review will add to the existing literature by showing compelling evidence and improved guidance in clinic settings.

OSF REGISTRATION NUMBER

10.17605/OSF.IO/DCRPJ.

ETHICS AND DISSEMINATION

Ethical approval and patient consent are not required because this study is a literature-based study. This systematic review and meta-analysis will be published in a peer-reviewed journal.

The Effect of Cognitive Behavioral Therapy on Depression, Anxiety, and Stress in Patients With COVID-19: A Randomized Controlled Trial

Background: As a public health emergency of international concern, the COVID-19 outbreak has had a tremendous impact on patients' psychological health. However, studies on psychological interventions in patients with COVID-19 are relatively rare. Objectives: This study examined the effectiveness of Cognitive Behavioral Therapy (CBT) in relieving patients' psychological distress during the COVID-19 epidemic. Methods: Ninety-three eligible participants selected by cluster sampling were randomized to an intervention group (N = 47) and a control group (N = 46). Participants in the control group received routine treatment according to the Chinese Management Guidelines for COVID-19, while participants in the intervention group received routine treatment with additional CBT. The Chinese Version of Depression Anxiety and Stress Scale-21 (DASS-21) was used to evaluate depression, anxiety, and stress for all participants at baseline and post-intervention. Two-sided t-test, and proportion tests were used to examine the differences between the intervention and control group for each DASS-21 indicator. Univariate linear regression was used to examine the association between chronic disease status and change in each DASS-21 indicator after intervention. Two-way scatter plots were generated to show the association of the length of hospital stay and the changes of each DASS-21 indicator by intervention and control groups. Results: Significant decreases in means were found for scales of depression, anxiety, stress and total DASS-21 in both intervention (p < 0.001) and control group (p = 0.001), with participants in the intervention group having a bigger reduction in means. After the intervention, more participants in the intervention group had no depression or anxiety symptoms than in the control group, but no statistical differences were found (p > 0.05). Compared with participants with chronic disease, participants with no chronic disease had a significantly larger reduction of total DASS-21 scale (coefficient = -4.74, 95% CI: -9.31; -0.17).The length of hospital stay was significantly associated with a greater increase in anxiety scale in the intervention group (p = 0.005), whilst no significant association was found in the control group (p = 0.29). Conclusions: The patients with COVID-19 experienced high levels of anxiety, depression and stress. Our study result highlights the effectiveness of CBT in improving the psychological health among patients with COVID-19, also suggests that CBT should be focused on patients with chronic disease and those who have longer hospital stays. These results have important implications in clinical practice in improving psychological health in the context of COVID-19 pandemic. Trial Registration: ISRCTN68675756. Available at: http://www.isrctn.com/ISRCTN68675756.

The European Academy for Cognitive Behavioural Therapy for Insomnia: An initiative of the European Insomnia Network to promote implementation and dissemination of treatment

Insomnia, the most prevalent sleep disorder worldwide, confers marked risks for both physical and mental health. Furthermore, insomnia is associated with considerable direct and indirect healthcare costs. Recent guidelines in the US and Europe unequivocally conclude that cognitive behavioural therapy for insomnia (CBT-I) should be the first-line treatment for the disorder. Current treatment approaches are in stark contrast to these clear recommendations, not least across Europe, where, if any treatment at all is delivered, hypnotic medication still is the dominant therapeutic modality. To address this situation, a Task Force of the European Sleep Research Society and the European Insomnia Network met in May 2018. The Task Force proposed establishing a European CBT-I Academy that would enable a Europe-wide system of standardized CBT-I training and training centre accreditation. This article summarizes the deliberations of the Task Force concerning definition and ingredients of CBT-I, preconditions for health professionals to teach CBT-I, the way in which CBT-I should be taught, who should be taught CBT-I and to whom CBT-I should be administered. Furthermore, diverse aspects of CBT-I care and delivery were discussed and incorporated into a stepped-care model for insomnia.