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Objective <p>This study aimed to investigate Item s associated with treatment response to a phone-based, CBT-I–centered digital intervention in patients with depressive disorders, with a primary focus on sleep-related improvement and its association with changes in depressive symptoms.</p> Methods <p>A total of 307 outpatients with depressive disorders were enrolled from a sleep disorders clinic and received a phone-based, CBT-I–centered digital intervention delivered via a mobile application, in addition to routine pharmacotherapy. The intervention primarily targeted sleep disturbances and incorporated CBT techniques and psychoeducation. Participants completed demographic questionnaires and were assessed using the Pittsburgh Sleep Quality Index (PSQI), Patient Health Questionnaire-9(PHQ-9), Patient Health Questionnaire-15 (PHQ-15), and Epworth Sleepiness Scale (ESS).Treatment response was defined as a ≥ 50% reduction in total PHQ-9 score. Item s influencing treatment response at weeks 8 and 12, as well as Item s associated with residual symptoms at week 12, were analyzed.</p> Results <p>Univariate analyses showed that age and education level were significantly associated with treatment response at both weeks 8 and 12 (<i>P</i> &lt; 0.05), whereas gender was not. Multivariate logistic regression indicated that younger age (&lt; 30 years) and longer disease duration (&gt; 3 years) were independently associated with poorer treatment outcomes at both follow-up points.At week 12, residual symptoms were significantly associated with younger age, longer disease duration, poorer sleep quality (higher PSQI scores), greater somatic symptom burden (PHQ-15), and increased daytime sleepiness (ESS).Multivariate analyses identified younger age, longer disease duration, and family history of depression as independent risk Item s for residual symptoms.</p> Conclusion <p>This real-world study suggests that a CBT-I–centered digital intervention primarily targeting sleep disturbances may be associated with concurrent improvements in depressive symptoms among patients with depression. Younger patients and those with longer illness duration appear to be at higher risk for poorer outcomes and persistent residual symptoms.</p> Clinical trial registration number <p>ChiCTR2500103629.</p>

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Effects of a phone-based, CBT-I–centered digital intervention on sleep and depressive symptoms in real-world clinical settings

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月29日

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  • Lili Yang,
  • Pan Yan,
  • You Xu,
  • Linlin Hu,
  • Jia Wei,
  • Mingfen Song,
  • Wenjuan Liu,
  • Hongjing Mao

摘要

Objective

This study aimed to investigate Item s associated with treatment response to a phone-based, CBT-I–centered digital intervention in patients with depressive disorders, with a primary focus on sleep-related improvement and its association with changes in depressive symptoms.

Methods

A total of 307 outpatients with depressive disorders were enrolled from a sleep disorders clinic and received a phone-based, CBT-I–centered digital intervention delivered via a mobile application, in addition to routine pharmacotherapy. The intervention primarily targeted sleep disturbances and incorporated CBT techniques and psychoeducation. Participants completed demographic questionnaires and were assessed using the Pittsburgh Sleep Quality Index (PSQI), Patient Health Questionnaire-9(PHQ-9), Patient Health Questionnaire-15 (PHQ-15), and Epworth Sleepiness Scale (ESS).Treatment response was defined as a ≥ 50% reduction in total PHQ-9 score. Item s influencing treatment response at weeks 8 and 12, as well as Item s associated with residual symptoms at week 12, were analyzed.

Results

Univariate analyses showed that age and education level were significantly associated with treatment response at both weeks 8 and 12 (P < 0.05), whereas gender was not. Multivariate logistic regression indicated that younger age (< 30 years) and longer disease duration (> 3 years) were independently associated with poorer treatment outcomes at both follow-up points.At week 12, residual symptoms were significantly associated with younger age, longer disease duration, poorer sleep quality (higher PSQI scores), greater somatic symptom burden (PHQ-15), and increased daytime sleepiness (ESS).Multivariate analyses identified younger age, longer disease duration, and family history of depression as independent risk Item s for residual symptoms.

Conclusion

This real-world study suggests that a CBT-I–centered digital intervention primarily targeting sleep disturbances may be associated with concurrent improvements in depressive symptoms among patients with depression. Younger patients and those with longer illness duration appear to be at higher risk for poorer outcomes and persistent residual symptoms.

Clinical trial registration number

ChiCTR2500103629.