Cognitive behavioural treatment of insomnia in individuals with persistent persecutory delusions: a pilot trial.

BACKGROUND AND OBJECTIVES: Insomnia is a putative causal factor for persecutory thinking. Recent epidemiological studies show a strong association of insomnia and paranoia. The clinical implication is that reducing insomnia will reduce paranoid delusions. This study, evaluating for the first time th...

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Main Authors: Myers, E, Startup, H, Freeman, D
Formato: Journal article
Idioma:English
Publicado em: 2011
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author Myers, E
Startup, H
Freeman, D
author_facet Myers, E
Startup, H
Freeman, D
author_sort Myers, E
collection OXFORD
description BACKGROUND AND OBJECTIVES: Insomnia is a putative causal factor for persecutory thinking. Recent epidemiological studies show a strong association of insomnia and paranoia. The clinical implication is that reducing insomnia will reduce paranoid delusions. This study, evaluating for the first time the treatment of insomnia in individuals with persecutory delusions, provides a test of this hypothesis. It was predicted that a brief cognitive behavioural intervention for insomnia (CBT-I) for individuals with persistent persecutory delusions and sleep difficulties would not only reduce the insomnia but that it would also reduce the paranoia. METHODS: Fifteen patients with persistent persecutory delusions and insomnia in the context of a psychotic disorder were each individually given a standard-format, four-session CBT-I intervention. Outcome assessments were conducted at pre-treatment, post-treatment and one-month follow-up. RESULTS: There were no missing data. Following the intervention, significant reductions were found in levels of insomnia and the persecutory delusions. The effect sizes were large, and the changes were maintained at the follow-up. At least two-thirds of participants made substantial improvements in insomnia and approximately half showed substantial reductions in the persecutory delusions. There were also reductions in levels of anomalies of experience, anxiety and depression. LIMITATIONS: The main limitations are the absence of a control group and unblinded assessments. A more methodologically rigorous evaluation of this intervention is now warranted. CONCLUSIONS: These preliminary findings suggest that CBT-I can be used to treat insomnia in individuals with persecutory delusions and that, consistent with the hypothesised causal role, it also lessens the delusions.
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spelling oxford-uuid:a707846c-dce9-45a0-a20c-d733b2e06ae82022-03-27T02:51:37ZCognitive behavioural treatment of insomnia in individuals with persistent persecutory delusions: a pilot trial.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:a707846c-dce9-45a0-a20c-d733b2e06ae8EnglishSymplectic Elements at Oxford2011Myers, EStartup, HFreeman, DBACKGROUND AND OBJECTIVES: Insomnia is a putative causal factor for persecutory thinking. Recent epidemiological studies show a strong association of insomnia and paranoia. The clinical implication is that reducing insomnia will reduce paranoid delusions. This study, evaluating for the first time the treatment of insomnia in individuals with persecutory delusions, provides a test of this hypothesis. It was predicted that a brief cognitive behavioural intervention for insomnia (CBT-I) for individuals with persistent persecutory delusions and sleep difficulties would not only reduce the insomnia but that it would also reduce the paranoia. METHODS: Fifteen patients with persistent persecutory delusions and insomnia in the context of a psychotic disorder were each individually given a standard-format, four-session CBT-I intervention. Outcome assessments were conducted at pre-treatment, post-treatment and one-month follow-up. RESULTS: There were no missing data. Following the intervention, significant reductions were found in levels of insomnia and the persecutory delusions. The effect sizes were large, and the changes were maintained at the follow-up. At least two-thirds of participants made substantial improvements in insomnia and approximately half showed substantial reductions in the persecutory delusions. There were also reductions in levels of anomalies of experience, anxiety and depression. LIMITATIONS: The main limitations are the absence of a control group and unblinded assessments. A more methodologically rigorous evaluation of this intervention is now warranted. CONCLUSIONS: These preliminary findings suggest that CBT-I can be used to treat insomnia in individuals with persecutory delusions and that, consistent with the hypothesised causal role, it also lessens the delusions.
spellingShingle Myers, E
Startup, H
Freeman, D
Cognitive behavioural treatment of insomnia in individuals with persistent persecutory delusions: a pilot trial.
title Cognitive behavioural treatment of insomnia in individuals with persistent persecutory delusions: a pilot trial.
title_full Cognitive behavioural treatment of insomnia in individuals with persistent persecutory delusions: a pilot trial.
title_fullStr Cognitive behavioural treatment of insomnia in individuals with persistent persecutory delusions: a pilot trial.
title_full_unstemmed Cognitive behavioural treatment of insomnia in individuals with persistent persecutory delusions: a pilot trial.
title_short Cognitive behavioural treatment of insomnia in individuals with persistent persecutory delusions: a pilot trial.
title_sort cognitive behavioural treatment of insomnia in individuals with persistent persecutory delusions a pilot trial
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