Avslutande kommentarer

De flesta patienter i denna studie med depression och/eller ångest och komorbid insomni får en reduktion i samtliga besvärsbilder genom en individuell, korttidsintervention med KBT-I. Sedda som grupp går patienterna från kliniska till subkliniska nivåer, såväl gällande insomni-, ångest- som depressionsbesvär. De kliniskt signifikanta förbättringarna är goda, men långt ifrån fullständiga. Det finns ett stort behov av dels en behandlingsmodell för komorbid insomni, dels en specifik behandling som riktar sig mot komorbid insomni.

De kausala länkarna mellan insomni å ena sidan och depression och ångest å andra sidan visar att dessa besvärsbilder är tätt förbundna med varandras utveckling. Det behövs en bättre förståelse och ett undersökande utav hur detta är möjligt. Den transdiagnostiska teorin kan utgöra en god grund för detta arbete. Behandlingsstudier med starkare design och bättre kontroll för differentialdiagnostiska överväganden likaså. Först när gemensamma

vidmakthållande mekanismer är teoretisk och empiriskt grundade kan behandlingar som drastiskt minskar lidandet och ger avsevärda kliniska signifikanta förbättringar för varje patient kunna se dagens ljus.

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