Prevalence, course, and comorbidity of insomnia and depression in young adults
Prevalence, course, and comorbidity of insomnia and depression in young adults
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DOI：
10.1093/sleep/31.4.473
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发表时间：
2008-04-01
期刊：
影响因子：
5.6
通讯作者：
Roessler, Wulf
中科院分区：
文献类型：
--
作者：
Buysse, Daniel J.;Angst, Jules;Roessler, Wulf
研究目的：(1)描述具有代表性的年轻成人样本中失眠的患病率和前瞻性病程；(2)描述失眠与抑郁之间的横断面和纵向关联。设计：纵向队列研究。环境：瑞士苏黎世社区。参与者：有代表性的分层人群样本。干预措施:没有。测量和结果：苏黎世研究前瞻性地评估了社区年轻人样本（n = 591）的精神、身体和睡眠症状，共进行了6次访谈，时间跨度为20年。我们区分了4种基于持续时间的失眠亚型：1个月失眠伴显著痛苦、2- 3周失眠、复发性短暂失眠和偶尔短暂失眠。1个月失眠症的年患病率随着时间的推移逐渐增加，累计患病率为20%，女性的风险大于2倍。在40%的研究对象中，随着时间的推移，失眠发展成更慢性的形式。伴有或不伴有抑郁症的失眠随着时间的推移高度稳定。在随后的访谈中，持续2周或更长时间的失眠预示着重度抑郁发作和重度抑郁障碍；17% - 50%的失眠症持续2周或更长时间的受试者在随后的访谈中出现重度抑郁发作。“纯粹的”失眠和“纯粹的”抑郁之间没有纵向相关性，而失眠合并抑郁与两者都有纵向相关性。结论：这项纵向研究证实了失眠症的持续性和失眠症患者随后抑郁的风险增加。数据支持失眠（由持续时间和频率定义）与抑郁症共病，而不是继发于抑郁症。
Study Objectives: (1) To describe the prevalence and prospective course of insomnia in a representative young-adult sample and (2) to describe the cross-sectional and longitudinal associations between insomnia and depression.Design: Longitudinal cohort study.Setting: Community of Zurich, Switzerland.Participants: Representative stratified population sample.Interventions: None.Measurements and Results: The Zurich Study prospectively assessed psychiatric, physical, and sleep symptoms in a community sample of young adults (n = 591) with 6 interviews spanning 20 years. We distinguished 4 duration-based subtypes of insomnia: 1-month insomnia associated with significant distress, 2- to 3-week insomnia, recurrent brief insomnia, and occasional brief insomnia. The annual prevalence of 1-month insomnia increased gradually over time, with a cumulative prevalence rate of 20% and a greater than 2-fold risk among women. In 40% of subjects, insomnia developed into more chronic forms over time. Insomnia either with or without comorbid depression was highly stable over time. Insomnia lasting 2 weeks or longer predicted major depressive episodes and major depressive disorder at subsequent interviews; 17% to 50% of subjects with insomnia lasting 2 weeks or longer developed a major depressive episode in a later interview. "Pure" insomnia and "pure" depression were not longitudinally related to each other, whereas insomnia comorbid with depression was longitudinally related to both.Conclusions: This longitudinal study confirms the persistent nature of insomnia and the increased risk of subsequent depression among individuals with insomnia. The data support a spectrum of insomnia (defined by duration and frequency) comorbid with, rather than secondary to, depression.