Residual insomnia in major depressive disorder: a systematic review

Frontiers in Psychiatry

Psychiatry

Alicja Dywel¹  Joanna Szarmach¹  Wiesław Jerzy Cubała¹  Olivia Strandberg¹  Adam Włodarczyk¹  Aleksander Kwaśny² 

[1] Department of Psychiatry, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland;null;

关键词: residual symptoms;    residual insomnia;    depression;    major depressive disorder;    psychopharmacology;    psychotherapy;    cognitive-behavioral therapy;    behavioral activation;   

DOI  :  10.3389/fpsyt.2023.1190415

 received in 2023-03-20, accepted in 2023-06-05,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionThe ultimate goal in major depressive disorder (MDD) treatment is recovery. A proportion of MDD patients with formal remission experience persistent difficulties, which impair their daily functioning. Residual insomnia is one of the most common residual symptoms. Patients with residual insomnia experience relapse significantly earlier and have a poor prognosis. Little is known about possible ways of treatment and what subtype of insomnia is mostly reported.MethodsA systematic literature review was carried out in PubMed and Web of Science to synthesize the current status of knowledge about effective treatment methods and insomnia subtypes in residual insomnia in MDD.ResultsA few non-pharmacological treatment methods e.g., Cognitive Behavioral Therapy for Insomnia (CBT-I), Mindfulness-Based Cognitive Therapy (MBCT), behavioral activation (BA) and pharmacological methods (gabapentin, clonazepam) have proven to mitigate residual insomnia. Cognitive Behavioral Therapy for Depression (CBT-D) ameliorates insomnia complaints to a limited extent. Mid-nocturnal insomnia is the most common residual insomnia subtype in MDD patients.ConclusionResidual insomnia is a very common complaint and most often appears as mid-nocturnal insomnia. Scarce data points out the benefits from pharmacotherapy, psychotherapy, and BA. More research is needed.

【 授权许可】

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Copyright © 2023 Kwaśny, Włodarczyk, Dywel, Szarmach, Strandberg and Cubała.