25% [2-3] GCBT. [DOI] /j.issn University, Chongqing , China

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1 [ ] (GCBT) GCBT (n=128) (n=113) (HAMA) (HAMD) (ISI)4 GCBT (SOL)(TST) (TIB) (NOA) (ISI) (P<0.05)(SE) HAMA HAMD (P>0.05) 8 GCBT SOL SE NOA HAMA HAMD ISI (P<0.05) TST TIB (P>0.05) GCBT GCBT GCBT [ ] [ ] R [ ] A [ ] (2018) [DOI] /j.issn The treatment effect of group cognitive behavioral therapy for insomnia HUANG Qing-ling 1, YUE Fa-guo 1, JIANG Cheng-gang 1, ZHANG Ting 1, LEI Li 1, WANG Yan-jiang 2, GAO Dong 1* 1 Department of Sleep and Psychology, 2 Department of Neurology, Research Institute of Field Surgery, Daping Hospital, Army Medical University, Chongqing , China * Corresponding author, gaodong1973@163.com [Abstract] Objective To explore the treatment effect of group cognitive behavioral therapy (GCBT) for patients with insomnia. Methods Two hundred and forty-one cases of insomnia were collected in the department of Sleep and Neurology Psychological in Daping Hospital and Field Surgery Research Institute of Army Medical University from March 2016 to June They were randomly divided into GCBT group (n=128) and pharmacotherapy group (n=113), and the treatment last for 8 weeks for each group. Then the differences of the sleep parameters, Insomnia Severity Index (ISI) scores, Hamilton Depression Scale (HAMD) scores and Hamilton Anxiety Scale (HAMA) scores were compared in two groups at per-treatment, four-week treatment time point and eight-week treatment time point. Results At the four week treatment time point, the differences of sleep onset latency (SOL), total sleep time (TST), time in bed (TIB), number of awakenings (NOA) and insomnia severity index (ISI) in GCBT group compared to pharmacotherapy group were statistically significant (P<0.05). While the differences of sleep efficiency (SE), HAMA and HAMD were of no statistically significant difference (P>0.05). At the eight week treatment time point, the differences of SOL, SE, NOA, HAMA, HAMD and ISI in GCBT group compared to pharmacotherapy group were statistically significant (P<0.05), and there is no significant difference in TST and TIB (P>0.05). Conclusion GCBT and pharmacotherapy can improve insomnia symptoms, reduce the level of anxiety and insomnia severity. GCBT can also reduce the level of depression, although GCBT improve insomnia symptoms were slower than pharmacotherapy, but curative effect is superior to pharmacotherapy, and it should be popularized in clinic. [Key words] insomnia; group cognitive behavioral therapy;anxiety; depression [ ] [ ] ( ) ( ) [ ] gaodong1973@163.com 25% 6%~10% [1] [2-3]

2 Med J Chin PLA, Vol. 43, No. 3, March 1, (cognitive behavioral therapy CBT) CBT (4~8 ) WHO [4] CBT [5] CBT [6] CBT(group CBT GCBT) [7] GCBT GCBT ( ) ~70 [8] 3 / 3<4 / GCBT 1 CBT 1.3 GCBT (sleep onset latency SOL) (number of awakenings NOA) (wake after sleep onset WASO) (time in bed TIB) (total sleep time TST) TST TIB (sleep efficiency SE) SE=TST/ TIB 100 (HAMA) [9] (HAMD) [10] (insomnia severity index ISI) [11] 1.5 SOL WASO TST TIB NOA 4 8 HAMA HAMD ISI GCBT 8 GCBT 1 75min 8~10 ( ) 2 TIB TST PPT 3 PPT 4 ( ) HAMA HAMD ISI 5 ( ) HAMA HAMD ISI min 3.75~7.50mg ( 7.5mg/ H ) 1 /d 8

3 HAMA HAMD ISI 1.6 SPSS 19.0 x±s t (%) χ 2 P< GCBT GCBT (P>0.05 1) 8 GCBT SOL TST TIB SE NOA HAMA HAMD ISI (P>0.05) 4 SOL NOA SE TST ISI (P<0.05) GCBT SOL TIB SE HAMA ISI (P<0.05) SOL TST TIB NOA ISI (P<0.05) SE HAMA HAMD (P>0.05) 8 GCBT SOL TST TIB SE NOA HAMA HAMD ISI (P<0.05) 4 SOL TST TIB NOA HAMA HAMD ISI (P<0.05) SOL TST SE NOA HAMA ISI (P<0.05) TIB HAMD (P>0.05) 4 SOL SE HAMA ISI (P<0.05) SOL SE NOA HAMA HAMD ISI (P<0.05) TST TIB (P>0.05 2) 3 1 Tab.1 Baseline characteristics of two groups Item GCBT (n=128) Pharmacotherapy (n=113) χ 2 /t P Female (n) Married (n) Hypnotics use in 1 months (n) Unemployment or retirement (n) Smoke, drink, tea or coffee (n) Age (year) Education (year) Insomnia duration (year) GCBT. Group cognitive behavioral therapy 2 (x±s) Tab.2 Changes of sleep parameters, anxiety and depression level, insomnia severity index in two groups (x±s) Item Pre-treatment 4 weeks 8 weeks GCBT Pharmacotherapy GCBT Pharmacotherapy GCBT Pharmacotherapy SOL (1)(3) (1) (1)(2)(3) (1)(2) TST (3) (1) (1)(2) (1) TIB (1)(3) (1)(2) SE (1) (1) (1)(3) (1)(2) NOA (3) (1) (1)(2)(3) (1) HAMA (1) (1)(2)(3) (1)(2) HAMD (1)(2)(3) ISI (1)(3) (1)(3) (1)(2)(3) (1)(2) GCBT. Group cognitive behavioral therapy; HAMD. Hamilton depression scale score; HAMA. Hamilton anxiety scale score. SOL. Sleep onset latency; TST. Total sleep time; TIB. Time in bed; SE. Sleep efficiency; NOA. Number of awakenings; ISI. Insomnia severity index; (1)P<0.05 compared with before treatment; (2)P<0.05 compared with 4 weeks treatment; (3)P<0.05 compared with pharmacotherapy group

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