Insomnia and Major Depressive Disorder: An Individualized Risk Prediction Model for Treatment Outcomes in Psychotherapy, Pharmacotherapy, and Combined Therapy

Oosterzee, Katja van (2022) Insomnia and Major Depressive Disorder: An Individualized Risk Prediction Model for Treatment Outcomes in Psychotherapy, Pharmacotherapy, and Combined Therapy. Master thesis, Psychology.

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Abstract

Major Depressive Disorder (MDD) is a highly prevalent mental disorder for which there exists much heterogeneity in treatment efficacy, making it difficult for clinicians to assess which treatment fits the best to a particular patient in advance. Much research indicates a bidirectional relationship between insomnia and the clinical course of MDD. However, only little research studied the predictive power of pre-treatment insomnia on MDD-treatment outcomes. This study examined whether pretreatment insomnia can predict remission and response in (individual) MDD-diagnosed patients and investigates whether the type of treatment received makes a difference. Participants received psychotherapy and/ or pharmacotherapy for 6 months. Remission, response and pretreatment insomnia were assessed with the Hamilton Rating Scale for Depression. Logistic regressions were used to assess the odds of remission and response according to pretreatment insomnia alone and in conjunction with treatment modality, after adjusting for baseline depression scores, gender and age. The Area under the Receiver Operating Characteristic curves was calculated to assess the ability to discriminate between (non)responders and (non)remitters. Results indicate that pretreatment insomnia decreases the odds of remission. Moreover, patients with pretreatment insomnia are more likely to achieve remission when they receive psychotherapy rather than pharmacotherapy. Additionally, pretreatment insomnia alone and in conjunction with treatment modality are somewhat able to discriminate between (non)remitters. All results for response were nonsignificant. The findings indicate that pretreatment insomnia might be one of the factors that are important in predicting MDD-treatment outcomes and that MDD-diagnosed patients might benefit more from psychotherapy when they experience insomnia.

Item Type:	Thesis (Master)
Supervisor name:	Booij, S.H.
Degree programme:	Psychology
Differentiation route:	Clinical Psychology (CP) [Master Psychology]
Date Deposited:	08 Jul 2022 10:18
Last Modified:	08 Jul 2022 10:18
URI:	http://gmwpublic.studenttheses.ub.rug.nl/id/eprint/796

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