The association of insomnia with anxiety disorders and depression: Exploration of the direction of risk
The association of insomnia with anxiety disorders and depression: Exploration of the direction of risk
复制标题
DOI：
10.1016/j.jpsychires.2006.07.008
复制
发表时间：
2006-12-01
影响因子：
4.8
通讯作者：
Breslau, Naomi
中科院分区：
文献类型：
--
作者：
Johnson, Eric O.;Roth, Thomas;Breslau, Naomi
本研究的目的是探讨失眠和焦虑症和抑郁症之间的关系，以社区为基础的样本中的青少年，以更好地了解他们的潜在病因关系的方向。数据来自1014名13-16岁青年的社区样本。进行结构化访谈以评估DSM-IV诊断。在比例风险模型中使用回溯报告的发病年龄，以估计与其他疾病先前发病相关的一种疾病的风险增加。DSM-IV失眠与每种焦虑症和抑郁症的终生相关性为中度（OR = 3.2-6.8）。在患有共病的患者中，73%的焦虑症发生在失眠之前，而在69%的失眠和抑郁症共病病例中，失眠首先发生。任何既往焦虑障碍与失眠风险增加相关，调整性别、种族/民族和失眠前抑郁（HR = 3.5）。然而，先前的失眠与焦虑症的发作没有显著相关。既往抑郁症与失眠发作无关，但既往失眠与调整性别、人种/种族和任何既往焦虑障碍后的抑郁发作相关（HR = 3.8）。这些结果表明，在青春期，DSM-IV失眠、焦虑和抑郁之间存在不同的自然发展过程。此外，失眠可能与焦虑症和抑郁症有独立的、潜在的病因学上不同的方向性关联。(c)2006爱思唯尔有限公司保留所有权利。
The purpose of this study is to explore the direction of the association between insomnia and anxiety disorders and major depression among a community-based sample of adolescents to better understand their potential etiologic relationships. Data come from a community-based sample of 1014 youth aged 13-16. Structured inter-views were conducted to assess DSM-IV diagnoses. Retrospectively reported ages of onset were used in Proportional Hazards models to estimate increased risk of one disorder associated with prior onset of the others. The lifetime associations of DSM-IV insomnia with each anxiety disorder and with depression were moderate (OR = 3.2-6.8). Among those with comorbid disorders, anxiety disorders preceded insomnia 73% of the time, while insomnia occurred first in 69% of comorbid insomnia and depression cases. Any prior anxiety disorder was associated with an increased risk of insomnia adjusting for gender, race/ethnicity, and depression prior to insomnia (HR = 3.5). However, prior insomnia was not significantly associated with onset of anxiety disorders. Prior depression was not associated with onset of insomnia, but prior insomnia was associated with onset of depression adjusting for gender, race/ethnicity, and any prior anxiety disorder (HR = 3.8). These results suggest distinct natural courses of development between DSM-IV insomnia, anxiety, and depression during adolescence. Additionally insomnia may have independent, and potentially etiologically distinct, directional associations with anxiety disorders versus depression. (c) 2006 Elsevier Ltd. All rights reserved.