Journal
FRONTIERS IN PSYCHIATRY
Volume 12, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fpsyt.2021.676962
Keywords
suicidal ideation; cognitive behavioral treatment for insomnia; depression; prediction; insomnia
Categories
Funding
- Promobilia Foundation
- Soderstrom-Konigska sjukhemmet Foundation
- Lars Hierta Foundation
- Fredrik & Ingrid Thuring Foundation
- Region Stockholm
- Psykiatrifonden
- Karolinska Institutet
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Insomnia disorder is a prevalent issue and a risk factor for many psychiatric problems. Cognitive behavioral therapy has been found to reduce insomnia symptoms and depressive symptoms. In a sample of patients primarily seeking online treatment for insomnia, CBT-I treatment led to improvements in suicidal ideation, with improvements in depressive symptoms being the strongest predictor of changes in suicidal ideation.
Insomnia disorder is highly prevalent, and has been identified as a risk factor for many psychiatric problems, including depression, suicide ideation and suicide death. Previous studies have found that cognitive behavioral therapy for insomnia (CBT-I) reduce depression and suicidal ideation in samples with high levels of suicidal ideation. This study aims to investigate associations of CBT-I with suicidal ideation in a sample of 522 patients primarily seeking internet-delivered treatment for insomnia in regular psychiatric care. The sample had high pretreatment insomnia severity levels and a relatively high level of comorbid depression symptoms. Suicidal ideation levels were relatively low pretreatment but still improved significantly after CBT-I. Contrary to previous findings, the strongest predictor of changes in suicidal ideation were improvements in depressive symptoms, rather than improvements in insomnia. We conclude that suicidal ideation may not be a major problem in these patients primarily seeking treatment for insomnia, despite comorbid depressive symptoms, but that suicidal ideation still improves following CBT-i. Considering the increased risk for patients with untreated insomnia to develop depression, this finding is of interest for prevention of suicidal ideation.
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