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Comment & Response
March 16, 2022

The Direct Effect of Cognitive Behavioral Therapy for Insomnia on Depression Prevention and the Mediation Effect via Insomnia Remission

Author Affiliations
  • 1Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
  • 2Institute of Statistics, National Yang-Ming Chiao-Tung University, Hsinchu, Taiwan
  • 3Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
JAMA Psychiatry. 2022;79(5):514-515. doi:10.1001/jamapsychiatry.2022.0149

To the Editor The study by Irwin et al1 found that cognitive behavioral therapy for insomnia (CBT-I) had an overall benefit in the prevention of incident and recurrent major depression compared with sleep education therapy (SET) in older adults with insomnia disorder. The authors used a predefined analysis to compare treatment groups as a function of sustained remission of insomnia disorder to test the superiority of CBT-I over SET in remission of insomnia disorder. We suggested that mediation analysis might be used to clarify the role of insomnia remission in the association between CBT-I and SET and the prevention of depression.

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