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Prevalence, Course, and Comorbidity of Insomnia and Depression in Young Adults. Commentary

TLDR
In this paper, the authors investigated the cross-sectional and longitudinal associations between insomnia and depression in a representative sample of young adults with 6 interviews spanning 20 years and distinguished four duration-based subtypes of insomnia: 1-month insomnia associated with significant distress, 2-to 3-week insomnia, recurrent brief insomnia, and occasional brief insomnia.
Abstract
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

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Insomnia as a predictor of depression: A meta-analytic evaluation of longitudinal epidemiological studies.

TL;DR: Non-depressed people with insomnia have a twofold risk to develop depression, compared to people with no sleep difficulties, so early treatment programs for insomnia might reduce the risk for developing depression in the general population and be considered a helpful general preventive strategy in the area of mental health care.
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A Systematic Review Assessing Bidirectionality between Sleep Disturbances, Anxiety, and Depression

TL;DR: Alvaro et al. as discussed by the authors investigated whether sleep disturbances are bidirectionally related to anxiety and depression, and thus identify potential risk factors for each problem, and found that childhood sleep problems significantly predicted higher levels of depression and a combined depression/anxiety variable, but not vice versa.
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Sleep and emotions: a focus on insomnia.

TL;DR: There is empirical evidence that dysfunctional emotional reactivity might mediate the interaction between cognitive and autonomic hyperarousal, thus contributing to the maintenance of insomnia, and the need for future research on emotions in insomnia is underlines.
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Cognitive behavioral therapy, singly and combined with medication, for persistent insomnia: a randomized controlled trial.

TL;DR: In patients with persistent insomnia, the addition of medication to CBT produced added benefits during acute therapy, but long-term outcome was optimized when medication is discontinued during maintenance CBT.
References
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Book

The analysis of cross-classified categorical data

TL;DR: The second edition has been updated and revised, with more emphasis on logic and logistic response properties and on the small-sample behavior of chi-square statistics as mentioned in this paper, and includes 40 to 50 new problems with most having separate data sheets.
Journal ArticleDOI

Sleep disturbance and psychiatric disorders: A longitudinal epidemiological study of young Adults

TL;DR: Prior insomnia remained a significant predictor of subsequent major depression when history of other prior depressive symptoms was controlled for, and complaints of 2 weeks or more of insomnia nearly every night might be a useful marker of subsequent onset of major depression.
Journal ArticleDOI

Insomnia in Young Men and Subsequent Depression The Johns Hopkins Precursors Study

TL;DR: It is suggested that insomnia in young men is indicative of a greater risk for subsequent clinical depression and psychiatric distress that persists for at least 30 years.
Journal ArticleDOI

Primary insomnia: a risk factor to develop depression?

TL;DR: It would be worthwhile to investigate if early adequate treatment is able to prevent psychiatric sequelae of primary insomnia, as insomniac symptoms alone seem to be of predictive value for the development of depression in the succeeding years.
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