Differential Co-Occurring Patterns Between Depressive Symptomatology and Sleep-Wake-Related Disturbances in Mood Disorders

Sze-Yu Chen; Chun-Hao Chen; Chen Lo; Mong-Liang Lu; Cheng-Dien Hsu; Yi-Hang Chiu; Chun-Hsin Chen; Shih-Ku Lin; Ming-Chyi Huang; Hsi-Chung Chen; Po-Hsiu Kuo

doi:10.2147/NSS.S301357

Differential Co-Occurring Patterns Between Depressive Symptomatology and Sleep-Wake-Related Disturbances in Mood Disorders

Nat Sci Sleep. 2021 Apr 27:13:503-514. doi: 10.2147/NSS.S301357. eCollection 2021.

Authors

Sze-Yu Chen¹, Chun-Hao Chen¹, Chen Lo¹, Mong-Liang Lu², Cheng-Dien Hsu³, Yi-Hang Chiu², Chun-Hsin Chen², Shih-Ku Lin^{4

5}, Ming-Chyi Huang⁵, Hsi-Chung Chen^{1

6}, Po-Hsiu Kuo^{1

7}

Affiliations

¹ Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.
² Department of Psychiatry, Wan-Fang Hospital & School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
³ Department of Psychosomatic Medicine, Taiwan Adventist Hospital, Taipei, Taiwan.
⁴ Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
⁵ Department of Psychiatry, Taipei City Hospital, Songde Branch, Taipei, Taiwan.
⁶ Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan.
⁷ Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.

Abstract

Purpose: This study aimed to elucidate the various co-occurring patterns of depressive symptomatology and sleep-wake-related disturbances (SWRDs) in patients with mood disorders.

Patients and methods: Individuals in non-acute states of major depressive disorder or bipolar disorder were recruited. The Beck Depression Inventory II (BDI-II) was utilized to evaluate depressive symptoms. BDI-II items were classified into three domains: cognitive, affective, and somatic. Between-domain differences with various SWRDs were examined. Latent class analysis was used to empirically classify participants using BDI-II items as indicator variables. Co-occurring patterns between domains of BDI-II items and SWRDs were re-examined in each subgroup to elucidate inter-individual differences.

Results: In total, 657 participants were enrolled. Of participants, 66.8% were female, and 52.4% were diagnosed with major depressive disorder. Each BDI-II domain exhibited different co-occurring patterns. The somatic domain was most likely to co-occur with various SWRDs. Three subgroups were derived from latent class analysis and were designated as poor sleep quality and high insomnia (n=150), poor sleep quality and moderate insomnia (n=248), and poor sleep quality and low insomnia (n=159). The group with more severe insomnia presented with more severe depressive and anxiety symptoms. The three subgroups further differed in co-occurring patterns. From the low insomnia to high insomnia group, the associations with various SWRDs appeared in the sequence of somatic, affective, and cognitive domains.

Conclusion: Co-occurring patterns between domains of depressive symptomatology with various SWRDs differ and may vary among individuals.

Keywords: co-occurring; depression; latent class analysis; mood disorders; sleep-wake-related disturbance.

Grants and funding

Participants recruitment was supported by National Taiwan University Hospital grant (UN110-021), Taiwan Ministry of Science and Technology (MOST) grants (105-2628-B-002-028-MY3, 108-2314-B-002-110-MY2, and 108-2314-B-002-136-MY3) and a grant from National Health Research Institute (NHRI-EX108-10627NI). The sponsor has no role in any of the stages from study design to submission of the paper for publication.