Psychological Medicine最新文献

{"title":"Persistent PTSD symptoms are associated with plasma metabolic alterations relevant to long-term health: A metabolome-wide investigation in women - Erratum.","authors":"Yiwen Zhu, Katherine H Shutta, Tianyi Huang, Raji Balasubramanian, Oana A Zeleznik, Clary B Clish, Julián Ávila-Pacheco, Susan E Hankinson, Laura D Kubzansky","doi":"10.1017/S0033291725000339","DOIUrl":"https://doi.org/10.1017/S0033291725000339","url":null,"abstract":"","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e57"},"PeriodicalIF":5.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A temporal network analysis of complex post-traumatic stress disorder and psychosis symptoms.","authors":"Peter Panayi, Alba Contreras, Emmanuelle Peters, Richard Bentall, Amy Hardy, Katherine Berry, William Sellwood, Robert Dudley, Eleanor Longden, Raphael Underwood, Craig Steel, Hassan Jafari, Liam Mason, Filippo Varese","doi":"10.1017/S0033291725000030","DOIUrl":"https://doi.org/10.1017/S0033291725000030","url":null,"abstract":"<p><strong>Background: </strong>Symptoms of complex post-traumatic stress disorder (cPTSD) may play a role in the maintenance of psychotic symptoms. Network analyses have shown interrelationships between post-traumatic sequelae and psychosis, but the temporal dynamics of these relationships in people with psychosis and a history of trauma remain unclear. We aimed to explore, using network analysis, the temporal order of relationships between symptoms of cPTSD (i.e. core PTSD and disturbances of self-organization [DSOs]) and psychosis in the flow of daily life.</p><p><strong>Methods: </strong>Participants with psychosis and comorbid PTSD (<i>N</i> = 153) completed an experience-sampling study involving multiple daily assessments of psychosis (paranoia, voices, and visions), core PTSD (trauma-related intrusions, avoidance, hyperarousal), and DSOs (emotional dysregulation, interpersonal difficulties, negative self-concept) over six consecutive days. Multilevel vector autoregressive modeling was used to estimate three complementary networks representing different timescales.</p><p><strong>Results: </strong>Our between-subjects network suggested that, on average over the testing period, most cPTSD symptoms related to at least one positive psychotic symptom. Many average relationships persist in the contemporaneous network, indicating symptoms of cPTSD and psychosis co-occur, especially paranoia with hyperarousal and negative self-concept. The temporal network suggested that paranoia reciprocally predicted, and was predicted by, hyperarousal, negative self-concept, and emotional dysregulation from moment to moment. cPTSD did not directly relate to voices in the temporal network.</p><p><strong>Conclusions: </strong>cPTSD and positive psychosis symptoms mutually maintain each other in trauma-exposed people with psychosis via the maintenance of current threat, consistent with cognitive models of PTSD. Current threat, therefore, represents a valuable treatment target in phased-based trauma-focused psychosis interventions.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e43"},"PeriodicalIF":5.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disrupted intersubject variability architecture in structural and functional brain connectomes in major depressive disorder.","authors":"Keke Fang, Baohong Wen, Liang Liu, Shaoqiang Han, Wenzhou Zhang","doi":"10.1017/S0033291725000078","DOIUrl":"https://doi.org/10.1017/S0033291725000078","url":null,"abstract":"<p><strong>Background: </strong>Major depressive disorder (MDD) is a heterogeneous condition characterized by significant intersubject variability in clinical presentations. Recent neuroimaging studies have indicated that MDD involves altered brain connectivity across widespread regions. However, the variability in abnormal connectivity among MDD patients remains understudied.</p><p><strong>Methods: </strong>Utilizing a large, multi-site dataset comprising 1,276 patients with MDD and 1,104 matched healthy controls, this study aimed to investigate the intersubject variability of structural covariance (IVSC) and functional connectivity (IVFC) in MDD.</p><p><strong>Results: </strong>Patients with MDD demonstrated higher IVSC in the precuneus and lingual gyrus, but lower IVSC in the medial frontal gyrus, calcarine, cuneus, and cerebellum anterior lobe. Conversely, they exhibited an overall increase in IVFC across almost the entire brain, including the middle frontal gyrus, anterior cingulate cortex, hippocampus, insula, striatum, and precuneus. Correlation and mediation analyses revealed that abnormal IVSC was positively correlated with gray matter atrophy and mediated the relationship between abnormal IVFC and gray matter atrophy. As the disease progressed, IVFC increased in the left striatum, insula, right lingual gyrus, posterior cingulate, and left calcarine. Pharmacotherapy significantly reduced IVFC in the right insula, superior temporal gyrus, and inferior parietal lobule. Furthermore, we found significant but distinct correlations between abnormal IVSC and IVFC and the distribution of neurotransmitter receptors, suggesting potential molecular underpinnings. Further analysis confirmed that abnormal patterns of IVSC and IVFC were reproducible and MDD specificity.</p><p><strong>Conclusions: </strong>These results elucidate the heterogeneity of abnormal connectivity in MDD, underscoring the importance of addressing this heterogeneity in future research.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e56"},"PeriodicalIF":5.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Loneliness and cognition in older adults: A meta-analysis of harmonized studies from the United States, England, India, China, South Africa, Mexico, and Chile.","authors":"Ji Hyun Lee, Angelina R Sutin, André Hajek, Selin Karakose, Damaris Aschwanden, Páraic S O'Súilleabháin, Yannick Stephan, Antonio Terracciano, Martina Luchetti","doi":"10.1017/S003329172500011X","DOIUrl":"10.1017/S003329172500011X","url":null,"abstract":"<p><strong>Background: </strong>Loneliness is a risk factor for late-life dementia. There is less consistent evidence of its association with cognitive performance. This study examined the replicability of the association between loneliness and overall and domain-specific cognitive function and informant-rated cognitive decline in cohorts from seven countries: the United States, England, India, China, South Africa, Mexico, and Chile.</p><p><strong>Methods: </strong>Data were from the Harmonized Cognitive Assessment Protocol administered in seven population-based studies (total N > 20,000). Participants reported their loneliness, completed a battery of cognitive tests, and nominated a knowledgeable informant to rate their cognitive decline. Random-effect meta-analyses were used to summarize the associations from each cohort.</p><p><strong>Results: </strong>Loneliness was associated with poor overall cognitive performance and informant-rated cognitive decline controlling for sociodemographic factors (meta-analytic correlation for overall cognition = -.10 [95% CI = -.13, -.06] and informant-rated decline = .16 [95% CI = .14, .17]). Despite some heterogeneity, the associations were significant across samples from Africa, Asia, Europe, North, Central, and South America. The meta-analysis also indicated an association with specific cognitive domains: episodic memory, speed-attention, visuospatial abilities, numeric reasoning, and verbal fluency. The associations were attenuated but persisted when depressive symptoms were added as a covariate. Depression, cognitive impairment, and sociodemographic factors did not consistently moderate the associations across samples.</p><p><strong>Conclusions: </strong>Loneliness is associated with poor performance across multiple domains of cognition and observer-rated cognitive decline, associations that replicated across diverse world regions and cultures.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e58"},"PeriodicalIF":5.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are delusions and/or referentiality associated with aberrant reward prediction error (RPE) signaling? Evidence from fMRI using a probabilistic monetary reward task.","authors":"María Ángeles García-León, Paola Fuentes-Claramonte, Abigail Gee, Nuria Ramiro-Sousa, Joan Soler-Vidal, Pilar Salgado-Pineda, Llanos Torres, Nuria Jaurrieta, Manel Sánchez-Pérez, Francesco Panicali, Emilio J Inarejos Clemente, Joaquim Raduà, Salvador Sarró, Raymond Salvador, Peter J McKenna, Edith Pomarol-Clotet","doi":"10.1017/S0033291724003258","DOIUrl":"https://doi.org/10.1017/S0033291724003258","url":null,"abstract":"<p><strong>Background: </strong>According to the aberrant salience proposal, reward processing abnormality, specifically erroneous reward prediction error (RPE) signaling due to stimulus-independent release of dopamine, underlies delusions in schizophrenia. However, no studies to date have examined RPE-associated brain activations in relation to this symptom.</p><p><strong>Methods: </strong>Seventy-eight patients with a DSM-5 diagnosis of schizophrenia/schizoaffective disorder and 43 healthy individuals underwent fMRI while they performed a probabilistic monetary reward task designed to generate a measure of RPE. Ratings of delusions and referentiality were made in the patients.</p><p><strong>Results: </strong>Using whole-brain, voxel-based analysis, schizophrenia patients showed only minor differences in RPE-associated activation compared to healthy controls. Within the patient group, however, severity of delusions was inversely associated with RPE-associated activation in areas including the caudate nucleus, the thalamus and the left pallidum, as well as the lateral frontal cortex bilaterally, the pre- and postcentral gyrus and supplementary motor area, the middle cingulate gyrus, and parts of the temporal and parietal cortex. A broadly similar pattern of association was seen for referentiality.</p><p><strong>Conclusions: </strong>According to this study, while patients with schizophrenia as a group do not show marked alterations in RPE signaling, delusions and referentiality are associated with reduced activation in parts of the prefrontal cortex and the basal ganglia, though not specifically the ventral striatum. The direction of the changes is on the face of it contrary to that predicted by aberrant salience theory.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e55"},"PeriodicalIF":5.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of studies using network analysis to assess dynamics of psychotic-like experiences in community samples.","authors":"Błażej Misiak, Aleksandra Pytel, Bartłomiej Stańczykiewicz","doi":"10.1017/S0033291725000261","DOIUrl":"https://doi.org/10.1017/S0033291725000261","url":null,"abstract":"<p><p>Several studies have used a network analysis to recognize the dynamics and determinants of psychotic-like experiences (PLEs) in community samples. Their synthesis has not been provided so far. A systematic review of studies using a network analysis to assess the dynamics of PLEs in community samples was performed. Altogether, 27 studies were included. The overall percentage ranks of centrality metrics for PLEs were 23.5% for strength (20 studies), 26.0% for betweenness (5 studies), 29.7% for closeness (6 studies), 26.9% for expected influence (7 studies), and 29.1% for bridge expected influence (3 studies). Included studies covered three topics: phenomenology of PLEs and associated symptom domains (14 studies), exposure to stress and PLEs (7 studies), and PLEs with respect to suicide-related outcomes (6 studies). Several other symptom domains were directly connected to PLEs. A total of 6 studies investigated PLEs with respect to childhood trauma (CT) history. These studies demonstrated that PLEs are directly connected to CT history (4 studies) or a cumulative measure of environmental exposures (1 study). Moreover, CT was found to moderate the association of PLEs with other symptom domains (1 study). Two studies that revealed direct connections of CT with PLEs also found potential mediating effects of cognitive biases and general psychopathology. PLEs were also directly connected to suicide-related outcomes across all studies included within this topic. The findings imply that PLEs are transdiagnostic phenomena that do not represent the most central domain of psychopathology in community samples. Their occurrence might be associated with CT and suicide risk.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e54"},"PeriodicalIF":5.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neural risk factors that predict the future onset of binge eating or compensatory weight control behaviors: A prospective 4-year fMRI study.","authors":"Eric Stice, Sonja Yokum, Jeff Gau, Heather Shaw","doi":"10.1017/S0033291724003337","DOIUrl":"https://doi.org/10.1017/S0033291724003337","url":null,"abstract":"<p><strong>Background: </strong>We conducted a prospective study to advance knowledge of biological factors that predict the future onset of binge eating and compensatory weight control behaviors because few biological risk factors for eating pathology have been identified.</p><p><strong>Methods: </strong>Adolescent girls free of binge eating or compensatory behaviors (<i>N</i> = 88; <i>M</i>_age = 14.5; [SD = 0.9]) completed functional magnetic resonance imaging tasks assessing individual differences in neural responsivity hypothesized to increase risk for onset of binge eating and compensatory behaviors, along with additional self-report measures, and were assessed over a 4-year follow-up.</p><p><strong>Results: </strong>Elevated responsivity of regions implicated in attention and valuation (dorsal anterior cingulate cortex; ventromedial prefrontal cortex) to thin models and lower responsivity of a reward valuation region (caudate) to anticipated milkshake tastes (which correlated with feeling fat) predicted the future onset of binge eating or compensatory behaviors over 4-year follow-up. Parental history of binge eating and compensatory behaviors, emotionality, weight/shape overvaluation, feeling fat, and elevated BMI also predicted the future onset of binge eating or compensatory behaviors.</p><p><strong>Conclusions: </strong>The evidence that elevated attentional bias for, and valuation of the thin ideal, in combination with lower valuation of high-calorie foods, predicted the future onset of eating-disordered behaviors are novel findings. The evidence that weight/shape overvaluation, feeling fat, elevated body mass, emotionality, and parental history of eating pathology predicted the future onset of eating-disordered behaviors extend past findings.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e48"},"PeriodicalIF":5.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological interventions for preventing relapse in individuals with partial remission of depression: a systematic review and individual participant data meta-analysis.","authors":"Joost Gülpen, Josefien J F Breedvelt, Eva A M van Dis, Gert J Geurtsen, Fiona C Warren, Cornelis van Heeringen, Caitlin Hitchcock, Fredrik Holländare, Marloes J Huijbers, Robin B Jarrett, Françoise Jermann, Margo de Jonge, Daniel N Klein, Nicola S Klein, S Helen Ma, Michael T Moore, Damiaan A J P Denys, J Mark G Williams, Willem Kuyken, Claudi L Bockting","doi":"10.1017/S0033291725000157","DOIUrl":"https://doi.org/10.1017/S0033291725000157","url":null,"abstract":"<p><p>Partial remission after major depressive disorder (MDD) is common and a robust predictor of relapse. However, it remains unclear to which extent preventive psychological interventions reduce depressive symptomatology and relapse risk after partial remission. We aimed to identify variables predicting relapse and to determine whether, and for whom, psychological interventions are effective in preventing relapse, reducing (residual) depressive symptoms, and increasing quality of life among individuals in partial remission. This preregistered (CRD42023463468) systematic review and individual participant data meta-analysis (IPD-MA) pooled data from 16 randomized controlled trials (<i>n</i> = 705 partial remitters) comparing psychological interventions to control conditions, using 1- and 2-stage IPD-MA. Among partial remitters, baseline clinician-rated depressive symptoms (<i>p</i> = .005) and prior episodes (<i>p</i> = .012) predicted relapse. Psychological interventions were associated with reduced relapse risk over 12 months (hazard ratio [HR] = 0.60, 95% confidence interval [CI] 0.43-0.84), and significantly lowered posttreatment depressive symptoms (Hedges' <i>g</i> = 0.29, 95% CI 0.04-0.54), with sustained effects at 60 weeks (Hedges' <i>g</i> = 0.33, 95% CI 0.06-0.59), compared to nonpsychological interventions. However, interventions did not significantly improve quality of life at 60 weeks (Hedges' <i>g</i> = 0.26, 95% CI -0.06 to 0.58). No moderators of relapse prevention efficacy were found. Men, older individuals, and those with higher baseline symptom severity experienced greater reductions in symptomatology at 60 weeks. Psychological interventions for individuals with partially remitted depression reduce relapse risk and residual symptomatology, with efficacy generalizing across patient characteristics and treatment types. This suggests that psychological interventions are a recommended treatment option for this patient population.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e50"},"PeriodicalIF":5.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Altered corticostriatal connectivity in long-COVID patients is associated with cognitive impairment.","authors":"Marie Troll, Meng Li, Tara Chand, Marlene Machnik, Tonia Rocktäschel, Antonia Toepffer, Johanna Ballez, Kathrin Finke, Daniel Güllmar, Jürgen R Reichenbach, Martin Walter, Bianca Besteher","doi":"10.1017/S0033291725000054","DOIUrl":"https://doi.org/10.1017/S0033291725000054","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has had a significant impact on the health of millions of people worldwide, and many manifest new or persistent symptoms long after the initial onset of the infection. One of the leading symptoms of long-COVID is cognitive impairment, which includes memory loss, lack of concentration, and brain fog. Understanding the nature and underlying mechanisms of cognitive impairment in long-COVID is important for developing preventive and therapeutic interventions.</p><p><strong>Methods: </strong>Our present study investigated functional connectivity (FC) changes in patients with long-COVID and their associations with cognitive impairment. Resting-state functional MRI data from 60 long-COVID patients and 52 age- and sex-matched healthy controls were analyzed using seed-based functional connectivity analysis.</p><p><strong>Results: </strong>We found increased FC between the right caudate nucleus and both the left and right precentral gyri in long-COVID patients compared with healthy controls. In addition, elevated FC was observed between the right anterior globus pallidus and posterior cingulate cortex as well as the right temporal pole in long-COVID patients. Importantly, the magnitude of FC between the caudate and the left precentral gyrus showed a significant negative correlation with Montreal Cognitive Assessment (MoCA) scores and a negative correlation with Trail Making Test B performance in the patient group.</p><p><strong>Conclusion: </strong>Patients with long-COVID present enhanced FC between the caudate and the left precentral gyrus. Furthermore, those FC alterations are related to the severity of cognitive impairment, particularly in the domain of executive functions.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e49"},"PeriodicalIF":5.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital CBT for insomnia and emotion regulation in the workplace: a randomised waitlist-controlled trial.","authors":"Talar R Moukhtarian, Sophie Fletcher, Lukasz Walasek, Krishane Patel, Carla Toro, Anna L Hurley-Wallace, Charlotte Kershaw, Sean Russel, Guy Daly, Nicole K Y Tang, Caroline Meyer","doi":"10.1017/S0033291725000194","DOIUrl":"https://doi.org/10.1017/S0033291725000194","url":null,"abstract":"<p><strong>Background: </strong>Cognitive behavioural therapy for insomnia (CBT-I) is the recommended first-line treatment for insomnia. However, scaling this proven effective intervention to areas of high need remains a challenge, necessitating sensitive adaptation and evaluation.</p><p><strong>Methods: </strong>A randomised waitlist-controlled trial evaluated the efficacy of a hybrid digital CBT-I and emotion regulation (dCBT-I + ER) intervention delivered through workplaces. Participants with at least mild insomnia and depression or anxiety symptoms were randomised to the intervention or waitlist control groups. The intervention was delivered via a web-based platform and four video-conferencing therapy sessions. Participants tracked their sleep using actigraphy and a sleep diary that was used to pace the intervention delivered. Assessments occurred at baseline and 8 weeks post-randomisation, measuring insomnia, depression, anxiety, psychological well-being, quality of life, and work productivity.</p><p><strong>Results: </strong>Of the 159 participants (mean age 43.6 ± 9.4 years, 76.7% female, 80.5% white), 80 received the intervention and 79 were in the control group. The intervention group showed significant improvements in insomnia (F1, 134 = 71.46, p < .0001); depression (F1, 134 = 35.67, p < .0001); and anxiety (F1, 134 = 17.63, p < .0001), with large effect sizes (d = 0.7-1.5). Sleep diary data supported these findings, whereas actigraphy data did not. Improvements in psychological well-being were significant (F1, 132.13 = 10.64, p < 0.001), whereas quality of life, work productivity, and satisfaction outcomes were not.</p><p><strong>Conclusions: </strong>This study suggests that a hybrid dCBT-I + ER intervention, delivered via workplaces, effectively improves insomnia, depression, and anxiety. It holds promise as a scalable solution, warranting further investigation into its long-term efficacy and economic impact.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e52"},"PeriodicalIF":5.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}