The Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TSC) in Community Mental Health: Evaluating Self-Reported Psychiatric Disorders as a Predictor of Symptoms and Treatment Outcome
In brief
More psychiatric diagnoses meant worse baseline health, but not poorer TSC response
Among 489 community mental health patients, having more self-reported psychiatric diagnoses was linked to worse psychiatric symptoms, sleep-related impairment, overall sleep health, and functioning at baseline. Diagnosis count did not predict treatment outcome, and common disorder groups improved more with TSC than usual care on sleep disturbance and related impairment; whether these gains last remains unknown.
- Journal
- Community mental health journal (Q1)
- Published
- 25 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Tanya B Horwitz, Laurel D Sarfan, Anne E Milner, Joshua Varghese, Catherine A Callaway, Allison G Harvey
- PMID
- 42789146
- DOI
- 10.1007/s10597-026-01719-1
Why clinicians should know about it
- Picked for Internal Medicine (top studies of the week, 27 September 2026): Ranked by evidence level and journal quartile
Abstract
This study investigated the extent to which number of psychiatric disorders and specific comorbidities in patients receiving the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TSC) predicted symptom/impairment severity and treatment outcome. This secondary analysis drew from a subset of 489 patients in Community Mental Health Centers (CMHCs) with serious mental illness (SMI) and sleep/circadian problems who had participated in a randomized controlled trial of TSC. Of these patients, 253 received Immediate TSC and 236 received usual care followed by delayed treatment (UC-DT). Some patients received Standard TSC (N = 149) while others received Adapted TSC (N = 340). Patients' baseline/pre-treatment and post-treatment scores for psychiatric symptoms, sleep disturbance, sleep-related impairment, overall sleep health, and functional impairment were analyzed. Patient-reported data on history of psychiatric diagnoses were also used. At baseline, patients with more disorders had significantly worse psychiatric symptom scores (b = 2.27, SE = 0.39, p<.001), marginally greater sleep disturbance (b = 0.57, SE = 0.32, p=.073) (but only at the nominal level), significantly greater sleep-related impairment (b = 1.25, SE = 0.34, p<.001), significantly worse overall sleep health (b=-0.20, SE = 0.06, p=.001), and significantly greater functional impairment (b = 0.32, SE = 0.11, p=.005). Number of psychiatric disorders was not associated with treatment outcome or differences in benefits between Standard and Adapted TSC. When analyzed independently, the most common psychiatric disorder groups all demonstrated significantly more improvement in the Immediate TSC group than in the UC-DT group on sleep disturbance and sleep-related impairment. These results build on strong evidence that transdiagnostic sleep treatment is an important approach to treating populations with comorbid SMI and sleep/circadian problems.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.