Comparative Meta-Analysis of Pharmacotherapy and Behavior Therapy for Persistent Insomnia
American Journal of PsychiatryPublished 1 January 2002
Michael T. Smith, Michael L. Perlis, Amy Park, Michelle S. Smith, JaeMi Pennington, Donna E. Giles
Citations861
SJR quartileQ1
SJR score5.27
SNIP3.68
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TL;DR
Overall, behavior therapy and pharmacotherapy produce similar short-term treatment outcomes in primary insomnia.
Abstract
Overall, behavior therapy and pharmacotherapy produce similar short-term treatment outcomes in primary insomnia.
Keywords
PsychologyNeuroscience
Computers Environment and Urban SystemsStatistical power analysis for the behavioral sciences
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