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dc.contributor.authorSheaves, Bryony
dc.contributor.authorWaite, Felicity
dc.contributor.authorHarrison, Paul J
dc.contributor.authorFreeman, Daniel
dc.date.accessioned2019-07-10T15:48:50Z
dc.date.available2019-07-10T15:48:50Z
dc.date.issued2019-05
dc.identifier.citationBryony Sheaves, Emily A. Holmes, Stephanie Rek,, Kathryn M. Taylor, Alecia Nickless, Felicity Waite,Anne Germain, Colin A. Espie, Paul J. Harrison , Russell Foster, Daniel Freeman. Cognitive Behavioural Therapy for Nightmares for Patients with Persecutory Delusions (Nites): An Assessor-Blind, Pilot Randomized Controlled Trial. Canadian Journal of Psychiatry, May 2019en
dc.identifier.issn14970015
dc.identifier.urihttps://oxfordhealth-nhs.archive.knowledgearc.net/handle/123456789/245
dc.description.abstractObjective:Nightmares are relatively common in patients experiencing psychosis but rarely assessed or treated. Nightmares may maintain persecutory delusions by portraying fears in sensory-rich detail. We tested the potential benefits of imagery-focused cognitive behavioural therapy (CBT) for nightmares on nightmare severity and persecutory delusions. Method:This assessor-blind parallel-group pilot trial randomized 24 participants with nightmares and persecutory delusions to receive CBT for nightmares delivered over 4 weeks in addition to treatment as usual (TAU) or TAU alone. Assessments were at 0, 4 (end of treatment), and 8 weeks (follow-up). Feasibility outcomes assessed therapy uptake, techniques used, satisfaction, and attrition. The primary efficacy outcome assessed nightmare severity at week 4. Analyses were intention to treat, estimating treatment effect with 95% confidence intervals (CIs). Results:All participants offered CBT completed therapy (mean [SD], 4.8 [0.6] sessions) with high satisfaction, and 20 (83%) participants completed all assessments. Compared with TAU, CBT led to large improvements in nightmares (adjusted mean difference = −7.0; 95% CI, –12.6 to –1.3; d = –1.1) and insomnia (6.3; 95% CI, 2.6 to 10.0; d = 1.4) at week 4. Gains were maintained at follow-up. Suicidal ideation was not exacerbated by CBT but remained stable to follow-up, compared with TAU, which reduced at follow-up (6.8; 95% CI, 0.3 to 3.3; d = 0.7). CBT led to reductions in paranoia (–20.8; 95% CI, –43.2 to 1.7; d = –0.6), although CIs were wide. Three serious adverse events were deemed unrelated to participation (CBT = 2, TAU = 1). Conclusions: CBT for nightmares is feasible and may be efficacious for treating nightmares and comorbid insomnia for patients with persecutory delusions. It shows promise on paranoia but potentially not on suicidal ideation.en
dc.description.sponsorshipSupported by the NIHRen
dc.description.urihttps://doi.org/10.1177/0706743719847422
dc.language.isoenen
dc.subjectCognitive Behaviour Therapyen
dc.subjectSleepen
dc.subjectParanoiaen
dc.subjectPersecutory Delusionsen
dc.titleCognitive Behavioural Therapy for Nightmares for Patients with Persecutory Delusions (Nites): An Assessor-Blind, Pilot Randomized Controlled Trialen
dc.typeArticleen


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