Do Sleep Disturbances Improve Following Psychoanalytic Psychotherapy for Adolescent Depression?

Abstract

Sleep disturbance is often a prominent symptom in adolescents diagnosed with major depressive disorder (MDD). Recent evidence indicates that short-term psychoanalytic psychotherapy (STPP) for depression may have an effect in reducing co-occurring sleep disturbance in youth. It is unknown if transference work (exploration of the patient–therapist relationship) has an additional effect in reducing sleep disturbance. Adolescents aged 16–18 years (n = 69, 84% female) who met diagnostic criteria for MDD based on the Mini International Neuropsychiatric Interview (M.I.N.I) were randomized to either STPP with transference work or without. Sleep problems were assessed at baseline, therapy session 20 (20 weeks), post-treatment (28 weeks), and one-year follow-up (80 weeks) with the Symptom Checklist-90-R. At baseline, 69% of the adolescents exhibited moderately to extreme sleep difficulties. Sleep disturbance was significantly correlated to depression depth at session 20 and at follow-up. Symptoms of insomnia significantly decreased from baseline to the end of treatment. Treatment gains were maintained until follow-up. No differences in recovery of sleep disturbance were found between the two treatment groups. The findings suggest that sleep disturbance improves following STPP for depression, with or without transference work. Future research should assess those with residual symptoms by different sleep measures.

Insomnia and Alexithymia in Chinese Adolescents with Major Depressive Disorder: A Cross-Sectional Study of Sex Differences and Associations

“…56 Therefore, insomnia in adolescent MDD patients needs other treatments, relevant researches has proven cognitive behavioral therapies (CBTs) 57 Recent studies suggested that short-term psychoanalytic psychotherapy (STPP) might help reducing sleep disturbances in early-onset MDD. 58 In this study, insomnia was related to higher BMI in male patients but lower BMI in female patients. But the relationship between insomnia and BMI remains to be controversial.…”

Effects of routine repetitive transcranial magnetic stimulation on the sleep duration of patients with treatment‐resistant depression: A prospective cohort study

“…There is evidence that in most patients with successful responses to antidepressants, even SSRIs, sleep symptoms improve in parallel with other depressive signs and symptoms 18 . This effect has also been observed in depressed people undergoing short‐term psychoanalytic psychotherapy 28 . Meanwhile, studies have shown that cognitive‐behavioral therapy targeting insomnia can improve responses to antidepressant therapies, leading to diminished depressive symptoms 29 .…”

“… 18 This effect has also been observed in depressed people undergoing short‐term psychoanalytic psychotherapy. 28 Meanwhile, studies have shown that cognitive‐behavioral therapy targeting insomnia can improve responses to antidepressant therapies, leading to diminished depressive symptoms. 29 Functional studies have also indicated that prefrontal cortex activity is impaired in both depression and sleep disturbances.…”

The mediating effect of sleep quality and fatigue between depression and renal function in nondialysis chronic kidney disease: a cross-sectional study

“…Nonetheless, related studies have found that impaired sleep continuity and disinhibition of rapid eye movement (REM) sleep in patients with depression lead to sleep problems [ 25 , 26 ]. Schønning et al performed short-term psychoanalytic psychotherapy on adolescents with depressive symptoms and found that sleep disturbances improved further after treatment for depression [ 27 ]. Fatigue and depression are complex constructs, they have been strongly correlated [ 28 ].…”