Efficacy of the Transdiagnostic Intervention for Sleep and Circadian Dysfunction for depression symptoms and sleep-wake disruption in older and younger adults: secondary age-stratified analysis of a randomized controlled trial
Abstract
Objective: Perform a secondary analysis examining the efficacy of the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) for depression symptom responses, and explore changes in potential target mechanisms. Design: Secondary analysis of a randomized controlled trial with convenience age subsamples (younger (20-49 year; n=52) versus and older (50-71 years; n=35)). Setting: Community mental health clinics Participants: Eighty-seven adults with serious mental illness Intervention: TranS-C versus treatment as usual (TAU) Measurements: Outcomes were depression symptoms (Quick Inventory of Depression Symptoms), insomnia symptoms (Insomnia Severity Index), and objective sleep-wake rhythm measures (inter-daily stability and relative amplitude). Results: Depression response rates (≥50% symptom reductions) were higher in the TranS-C (35.0%) than the TAU (8.8%) group six-months post-intervention (Chi-square =10.3, p=0.001). There was a medium effect of TranS-C versus TAU on depression symptoms six-months post-intervention (Cohen’s d=−0.40, 95% confidence interval (CI): −0.81, 0.01). In both age groups, there were large treatment effects on insomnia symptoms post-treatment (Cohen’s d>0.90). In the older subsample, there were additionally medium treatment effects on post-treatment inter-daily stability (Cohen’s d=0.60, 95% CI: −0.11, 1.61). Post-treatment reductions in insomnia symptoms correlated with depression symptom reduction six-months later in the younger…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 52 participants or records.
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