Evidence on Digital Mental Health Interventions for Adolescents and Young People: Systematic Overview

JMIR Mental Health, Journal Year: 2021, Volume and Issue: 8(4), P. e25847 - e25847

Published: March 10, 2021

An estimated 1 in 5 adolescents experience a mental health disorder each year; yet because of barriers to accessing and seeking care, most remain undiagnosed untreated. Furthermore, the early emergence psychopathology contributes lifelong course challenges across broad set functional domains, so addressing this life is essential. With increasing digital connectivity, including low- middle-income countries, technologies are considered promising for among young people. In recent years, growing number interventions, more than 2 million web-based apps, have been developed address range issues.

Language: Английский

---

Insomnia disorder: State of the science and challenges for the future

Journal of Sleep Research, Journal Year: 2022, Volume and Issue: 31(4)

Published: April 22, 2022

Summary Insomnia disorder comprises symptoms during night and day that strongly affect quality of life wellbeing. Prolonged sleep latency, difficulties to maintain early morning wakening characterize complaints, whereas fatigue, reduced attention, impaired cognitive functioning, irritability, anxiety low mood are key daytime impairments. is well acknowledged in all relevant diagnostic systems: Diagnostic Statistical Manual the American Psychiatric Association, 5th revision, International Classification Sleep Disorders, 3rd version, Diseases, 11th revision. as a chronic condition frequent (up 10% adult population, with preponderance females), signifies an important independent risk factor for physical and, especially, mental health. diagnosis primarily rests on self‐report. Objective measures like actigraphy or polysomnography not (yet) part routine canon, but play role research. Disease concepts insomnia range from cognitive‐behavioural models (epi‐) genetics psychoneurobiological approaches. The latter derived knowledge about basic sleep–wake regulation encompass theories rapid eye movement instability/restless sleep. Cognitive‐behavioural led conceptualization therapy insomnia, which now considered first‐line treatment worldwide. Future research strategies will include combination experimental paradigms neuroimaging may benefit more attention dysfunctional overnight alleviation distress insomnia. With respect therapy, merits widespread implementation, digital assist delivery along guidelines. However, given still considerable proportion patients responding insufficiently fundamental studies highly necessary better understand brain behavioural mechanisms underlying Mediators moderators response/non‐response associated development tailored novel interventions also require investigation. Recent suggest prove add significantly preventive strategy combat global burden disorders.

Language: Английский

---

Systematic review and meta-analysis on fully automated digital cognitive behavioral therapy for insomnia

npj Digital Medicine, Journal Year: 2025, Volume and Issue: 8(1)

Published: March 12, 2025

Insomnia impairs daily functioning and increases health risks. Cognitive behavioral therapy for insomnia (CBT-I) is effective but limited by cost therapist availability. Fully automated digital CBT-I (FA dCBT-I) provides an accessible alternative without involvement. This systematic review meta-analysis evaluated the effectiveness of FA dCBT-I across 29 randomized controlled trials (RCTs) involving 9475 participants. Compared to control groups, demonstrated moderate large effects on severity. Subgroup analyses indicated that had a significant impact when contrasted with most groups was less than therapist-assisted CBT-I. Meta-regression revealed group type moderated outcomes, whereas completion rate did not. implies treatment adherence, rather merely completing intervention, crucial its effectiveness. study supports potential as promising option managing underscores hybrid model combining support more beneficial.

Language: Английский

---

Digital and AI-Enhanced Cognitive Behavioral Therapy for Insomnia: Neurocognitive Mechanisms and Clinical Outcomes

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(7), P. 2265 - 2265

Published: March 26, 2025

Background/Objectives: This systematic review explores the integration of digital and AI-enhanced cognitive behavioral therapy (CBT) for insomnia, focusing on underlying neurocognitive mechanisms associated clinical outcomes. Insomnia significantly impairs functioning, overall health, quality life. Although traditional CBT has demonstrated efficacy, its scalability ability to deliver individualized care remain limited. Emerging AI-driven interventions-including chatbots, mobile applications, web-based platforms-present innovative avenues delivering more accessible personalized insomnia treatments. Methods: Following PRISMA guidelines, this synthesized findings from 78 studies published between 2004 2024. A search was conducted across PubMed, Scopus, Web Science, PsycINFO. Studies were included based predefined criteria prioritizing randomized controlled trials (RCTs) high-quality empirical research that evaluated AI-augmented interventions targeting sleep disorders, particularly insomnia. Results: The suggest improves parameters, patient adherence, satisfaction, personalization in alignment with individual profiles. Moreover, these technologies address critical limitations conventional CBT, notably those related access scalability. AI-based tools appear especially promising optimizing treatment delivery adapting cognitive-behavioral patterns. Conclusions: While demonstrates strong potential advancing through broader accessibility, several challenges persist. These include uncertainties surrounding long-term practical implementation barriers, ethical considerations. Future large-scale longitudinal is necessary confirm sustained benefits AI-powered

Language: Английский

---

A Pilot Randomized Controlled Trial of the Insomnia Coach Mobile App to Assess Its Feasibility, Acceptability, and Potential Efficacy

Behavior Therapy, Journal Year: 2021, Volume and Issue: 53(3), P. 440 - 457

Published: Nov. 19, 2021

Language: Английский

---

Insomnia, depression, and anxiety symptoms interact and individually impact functioning: A network and relative importance analysis in the context of insomnia

Sleep Medicine, Journal Year: 2022, Volume and Issue: 101, P. 505 - 514

Published: Dec. 8, 2022

Insomnia, depression, and anxiety show high rates of comorbidity functional impairment. Transdiagnostic symptom interactions may be implicated in this comorbidity. This network analysis sought to assess how symptoms insomnia, interact individually predict impairment across several domains for individuals with insomnia. Baseline psychometric data from a randomised controlled trial were analysed (N = 1711). A regularized partial correlation was estimated the data. Centrality (symptom connectivity), community structure clustering), bridging (inter-community connectivity) assessed. The replicability model assessed via confirmatory analyses holdout sample. Separately, Shapley values determine relative importance each predicting functioning (i.e., psychological wellbeing, psychosocial functioning, physical health impairment). most connected nodes uncontrollable worrying; trouble relaxing; depressed mood/hopelessness. Five communities identified relaxing as bridge between communities. showed good fit Low energy depressive affect (feelings failure/guilt; mood/hopelessness; anhedonia) key predictors multiple Trouble clinical transdiagnostic significance context In terms relate it clear that, while low feelings failure/guilt prominent predictors, range are associated Consideration both useful determining targets treatment. is secondary an original trial. Trial registration number: ISRCTN60530898. Registry URL: https://www.isrctn.com/ISRCTN60530898

Language: Английский

---

Disseminating cognitive behavioural therapy (CBT) for insomnia at scale: capitalising on the potential of digital CBT to deliver clinical guideline care

Journal of Sleep Research, Journal Year: 2023, Volume and Issue: 32(6)

Published: Aug. 29, 2023

Summary Cognitive behavioural therapy (CBT) is the recommended first‐line treatment for insomnia. However, guideline care very seldom available and most patients receive no treatment, or less effective second‐line pharmacotherapy sleep hygiene, neither of which are evidence‐based chronic The primary challenge CBT has been supply. There not enough therapists to meet enormous demand. We must accelerate clinician training, but this approach can never be sufficient, even with abbreviated, efficient therapies. Fortunately, however, landscape also changed dramatically. Fully‐automated digital (dCBT) emerged as a safe, effective, scalable delivery format. dCBT software only, so it disseminated readily widely medication. Moreover, integrated into services. Just medications delivered through health professionals systems, approved programmes same. an ecosystem psychologically‐based should necessitate medical prescription model. Our proposed stepped framework, comprises both population clinical service initiatives, enabling universal access diverse ways in may (in‐person, face‐to‐face, using telehealth, group therapy, digitally) operate congruently efficiently optimise people at all levels complexity need. With safe clinically products now set become established treatments, clearly differentiated from wellness apps, there potential rapidly transform insomnia services and, first time, deliver international scale.

Language: Английский

---

Improving sleep after stroke: A randomised controlled trial of digital cognitive behavioural therapy for insomnia

Journal of Sleep Research, Journal Year: 2023, Volume and Issue: 33(2)

Published: July 5, 2023

Stroke is frequently accompanied by long-term sleep disruption. We therefore aimed to assess the efficacy of digital cognitive behavioural therapy for insomnia improve after stroke. A parallel group randomised controlled trial was conducted remotely in participant's homes/online. Randomisation online with minimisation between-group differences age and baseline Sleep Condition Indicator-8 score. In total, 86 community-dwelling stroke survivors consented, whom 84 completed assessments (39 female, mean 5.5 years post-stroke, 59 old), were or control (sleep hygiene information). Follow-up at post-intervention (mean 75 days baseline) 8 weeks later. The primary outcome self-reported symptoms, as per (range 0-32, lower numbers indicate more severe insomnia, reliable change 7 points) post-intervention. There significant improvements compared (intention-to-treat, n = 48, 36, 5 imputed datasets, effect p ≤ 0.02,

Language: Английский

---

Adopting STOPP/START Criteria Version 3 in Clinical Practice: A Q&A Guide for Healthcare Professionals

Drug Safety, Journal Year: 2024, Volume and Issue: 47(11), P. 1061 - 1074

Published: July 11, 2024

The growing complexity of geriatric pharmacotherapy necessitates effective tools for mitigating the risks associated with polypharmacy. Screening Tool Older Persons' Potentially Inappropriate Prescriptions (STOPP)/Screening to Alert doctors Right Treatment (START) criteria have been instrumental in optimizing medication management among older adults. Despite their large adoption improving reduction potentially inappropriate medications (PIM) and patient outcomes, implementation STOPP/START faces notable challenges. extensive number latest version time constraints primary care pose practical difficulties, particularly settings a high patients. This paper critically evaluates challenges evolving implications applying third across various clinical settings, focusing on European healthcare context. Utilizing "Questions & Answers" format, it examines criteria's discusses relevant suitability potential adaptations address diverse needs different environments. By emphasizing these aspects, this aims contribute ongoing discourse enhancing safety efficacy population, promote more person-centred an aging society.

Language: Английский

---

Perspectives on increasing the impact and reach of CBT-I

SLEEP, Journal Year: 2023, Volume and Issue: 46(12)

Published: Oct. 31, 2023

Cognitive behavioral therapy for insomnia is now recognized as the front-line treatment chronic insomnia, yet many challenges remain in improving its impact and reach. This manuscript describes our perspective on some of these challenges. Based literature that maladaptive cognitions predict low adherence high levels cognitive-emotional hyperarousal may be associated with poor outcomes, we propose added focus cognitive strategies CBT-I. Specifically, broadening range traditional strategies, utilizing acceptance-based fuller integration broadened into CBT-I throughout course treatment. We also highlight a few other promising emerging approaches to enhance These include involving partners promote recommendations, using culturally relevant adaptations increase retention patients treatment, timely identification barriers engagement. public health by integrating support reduction long-term use hypnotic sleep medications, which line current medical guidelines. advocate case conceptualization-based approach implementing patient-centered manner, flexibly, fidelity, addressing factors above. For increasing reach CBT-I, discuss need train more clinicians ways combine therapist digital deliveries highlighting stepped care strategies.

Language: Английский

---