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Clinical Effectiveness of Group Cognitive-behavioral Therapy for Primary and Secondary Insomnia

Yi-Chih Chen, M.D.1 Yu-Shu Huang, M.D.2,3 Chih-Ken Chen, M.D., Ph.D.1,2

Objective:Long-term sleep problems affect personal functioning and create a burden on the health care system. The aim of this study was to evaluate the effectiveness of group cognitive-behavioral therapy (CBT) for patients with insomnia. In addition, we investigated whether patients with primary insomnia and those with secondary insomnia respond differently to group CBT. Methods:Sixty patients were recruited from the sleep disorder clinic at a general hospital in northern Taiwan. Each patient participated in a 90-minute group session once a week for 6 weeks. The assessments for effi cacy included sleep diary, Zung Anxiety Scale,Beck Depression Inventory, the 36-Item Short-Form Health Survey (SF-36). Results:For those who completed the entire program (n=41, 68.3%), there were signifi cant improvements in sleep latency, Zung Anxiety Scale, Beck Depression Inventory, and the vitality and general mental health subscales of the SF-36, but not in total sleeping time, number of awakening and sleep effi ciency. Sleep latency and the score on the Zung Anxiety Scale improved signifi cantly for those with secondary insomnia but not for those with primary insomnia. Conclusion: Group CBT is effective in improving sleep latency, and the effectiveness is more signifi - cant for insomnia with comorbid anxiety or depressive disorders than for primary insomnia.
Key Word insomnia, group cognitive-behavioral therapy, sleep, anxiety
Editorial Committe, Taiwanese Journal of Psychiatry
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