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@ARTICLE{Haritos:1045049,
      author       = {Haritos, Rafailia and Küppers, Vincent and Samea, Fateme
                      and Riemann, Dieter and Jessen, Frank and Eickhoff, Simon
                      and Forugh S. Dafsari, and Tahmasian, Masoud},
      title        = {{T}he effect of psychotherapy on the multivariate
                      association between insomnia and depressive symptoms in
                      late-life depression},
      journal      = {European psychiatry},
      volume       = {68},
      number       = {1},
      issn         = {0924-9338},
      address      = {Cambridge},
      publisher    = {Cambridge University Press},
      reportid     = {FZJ-2025-03491},
      pages        = {},
      year         = {2025},
      abstract     = {Background Late-life depression (LLD) is prevalent in older
                      adults and linked to increased disability, mortality, and
                      suicide risk. Insomnia symptoms are considered common
                      remaining symptoms of LLD following treatment. However, the
                      multivariate relationship between insomnia and depressive
                      symptoms and the impact of psychotherapy on their
                      interrelationship is insufficiently assessed.Methods We used
                      data from 185 patients with LLD recruited from seven
                      university hospitals in Germany. Participants had undergone
                      eight-week psychotherapy interventions (cognitive behavioral
                      therapy or supportive unspecific intervention). Three
                      regularized canonical correlation analyses (rCCA) assessed
                      the multivariate association between insomnia and depressive
                      symptoms at baseline, post-treatment, and six-month
                      follow-up. rCCA was conducted within a machine learning
                      framework with 100 repeated hold-out splits and permutation
                      tests to ensure robust findings. Canonical loadings and
                      cross-loading difference scores were calculated to examine
                      symptom changes before/after psychotherapy (Holm-Bonferroni
                      corrected p-value < 0.05).Results At baseline, a moderate
                      association was observed between insomnia and depressive
                      symptoms (r = 0.24). Interestingly, this association
                      slightly increased after the eight-week treatment period (r
                      = 0.42, pcorrected = 0.064) and remained significantly
                      elevated at the follow-up session (r = 0.49, pcorrected =
                      0.018). At baseline, anxiety-related depressive symptoms
                      were mainly associated with insomnia, while at
                      post-treatment and follow-up sessions, somatic and negative
                      affective symptoms showed the strongest correlation with
                      insomnia symptoms. Although depressive symptoms
                      significantly improved, insomnia symptoms remained unchanged
                      after psychotherapy.Conclusions Unlike depressive symptoms,
                      insomnia symptoms did not improve after psychotherapy,
                      highlighting the necessity to target insomnia for effective
                      LLD treatment.},
      cin          = {INM-7},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-7-20090406},
      pnm          = {5251 - Multilevel Brain Organization and Variability
                      (POF4-525) / 5252 - Brain Dysfunction and Plasticity
                      (POF4-525)},
      pid          = {G:(DE-HGF)POF4-5251 / G:(DE-HGF)POF4-5252},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {40898414},
      UT           = {WOS:001562232900001},
      doi          = {10.1192/j.eurpsy.2025.10088},
      url          = {https://juser.fz-juelich.de/record/1045049},
}