Short and long-term effects of cognitive behavioral therapy on sleep problems and psychotic symptoms in patients with psychotic disorders: a meta-analysis.

Abstract

Objective: Sleep problems are common in patients with psychotic disorders, especially schizophrenia. Although pharmacological methods are at the forefront of treatment, they have some drawbacks. Cognitive behavioral therapy for insomnia (CBT-I) is an option for the treatment of individuals with insomnia; in recent years, interest in its use in patients with psychotic disorders has been increasing. This meta-analysis aims to evaluate the effectiveness of CBT-I for sleep problems in patients with psychotic disorders.

Methods: A systematic search of the PubMed, Scopus, and EBSCO (MEDLINE) databases was conducted to identify relevant studies. The inclusion criteria were randomized controlled trials (RCTs) and uncontrolled studies that focused on participants diagnosed with schizophrenia, schizoaffective disorder, delusional disorder, psychotic disorders not otherwise specified, bipolar disorders, or unipolar depression with psychotic features, who had had sleep problems for at least 1 month, and who were receiving treatment. The initial search yielded 246 studies, of which eight were ultimately selected for meta-analysis after screening and applying inclusion and exclusion criteria. Statistical analysis was conducted in the R software environment.

Results: CBT-I significantly ameliorates insomnia and sleep quality in patients with psychotic disorders in both the short and long term. Additionally, CBT-I leads to significant improvement in psychotic symptoms in the short-term period and contributes significantly to improvement in mental well-being in both short- and long-term follow-up.

Conclusions: CBT-I is an effective, valuable method for sleep problems in patients with psychotic disorders. Its widespread use for this purpose is recommended.