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Copyright ©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Feb 19, 2026; 16(2): 110880
Published online Feb 19, 2026. doi: 10.5498/wjp.v16.i2.110880
Cognitive intervention based on Positive Emotion-Engagement Relationship-Meaning-Achievement theory in patients with depression and insomnia: Application value
Shu-Ying Li, Ping Rao
Shu-Ying Li, Ping Rao, Department of Psychiatry, Ganzhou People’s Hospital, Ganzhou 341000, Jiangxi Province, China
Author contributions: Li SY was responsible for conceptualization, methodology, investigation, data curation, and writing the original draft; Rao P was responsible for supervision, project administration, resources, writing review, editing, and funding acquisition; all authors have read and approved the final manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Ganzhou People's Hospital, approval No. ZY2024-23.
Clinical trial registration statement: This study was not registered as a clinical trial. It was designed as a prospective randomized controlled trial, with all interventions and assessments conducted within the hospital setting without registration on an external clinical trial platform.
Informed consent statement: Written informed consent was obtained from all participants prior to their involvement in the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: The data generated and analyzed during this study are available from the corresponding author upon reasonable request. Data access is subject to compliance with ethical approval requirements and may only be used for academic research purposes.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ping Rao, Department of Psychiatry, Ganzhou People’s Hospital, No. 17 Hongqi Avenue, Zhanggong District, Ganzhou 341000, Jiangxi Province, China. 15083737752@163.com
Received: July 29, 2025
Revised: August 26, 2025
Accepted: November 12, 2025
Published online: February 19, 2026
Processing time: 184 Days and 22.8 Hours
Core Tip

Core Tip: This randomized controlled trial demonstrates that cognitive intervention based on the Positive Emotion, Engagement, Relationships, Meaning, Achievement (PERMA) theory significantly improves outcomes in patients with comorbid depression and insomnia. Compared to conventional therapy, the PERMA-based approach reduced depressive symptoms (17-item Hamilton Depression Scale/Self-rating Depression Scale), enhanced sleep quality (Pittsburgh Sleep Quality Index), and improved cognitive function (Repeatable Battery for the Assessment of Neuropsychological Status), social performance (Chinese version of the Personal and Social Performance Scale), and quality of life (World Health Organization Abbreviated Quality of Life Scale). The findings highlight PERMA’s dual-action benefits - addressing both psychological distress and sleep dysfunction - through positive psychology principles, offering a novel, non-pharmacological strategy for this high-comorbidity population. Clinical adoption could optimize holistic patient recovery.